Become a Member of LICA

Individual Membership

Corporate Membership

One member from your organization

All breakfast meetings at no charge

Membership badge

A membership listing and company description on the LICA web site

Three members from your organization

All breakfast meetings at no charge

Membership badges

Membership listings and company description on the LICA web site

Company listing as a supporter of LICA

Step 1 :: Choose a type of membership
	Individual ($150 for 1 person) Corporate ($400 for 3 people)

Step 2 :: Tell us about yourself
* First name
* Last name
* Company
* Title
* Brief description of what your organization does
* Member Category	Capital Provider / Investor Seeking Capital Other
* Payment Method	Check to follow Online Credit Card/Paypal
Step 3 :: Member sign in :: this will be your login to the members area
* Email
* Password
Step 4 :: Contact details
* Phone
Mobile
Fax
Address 1
Address 2
City
State
Zip
Website	* PLEASE NOTE - USE THIS FORMAT * http://www.licapital.org
Step 5 :: Enter your comments then click the button below to submit your application
Comments

Step 2 :: Tell us about the company
*Company
Brief description of what your organization does
*Address 1
Address 2
*City
*State
*Zip
Website	* PLEASE NOTE - USE THIS FORMAT * http://www.licapital.org
Payment Method	Check to follow Online Credit Card/Paypal
Step 3 :: Primary Member sign in :: this will be your login to the Corporate area
*Email
*Password
Step 4 :: Primary Member Contact details
*First Name
*Last Name
Title
*Phone
Mobile
Fax
Step 5 :: Submit Secondary Member information :: this can be changed later
Secondary Member 1
First Name
Last Name
Title
Phone
Mobile
Fax
Email
Password
Secondary Member 2
First Name
Last Name
Title
Phone
Mobile
Fax
Email
Password
Step 6 :: Click the button below to submit your application
Comments

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3.12.2010
Capital Forum

Come join us Mar 12th at 8am to learn about the business plans and the investment opportunities of regional emerging companies.

Need Directions?
Click for a map/directions to
68 S. Service Rd, Melville

Questions?
Call 516.338.1801
or contact us online

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