Holiday Stroll Participation Form

Contact Name (required)

Business Name (required)

Your Email (required)

Address (required)

Phone Number (required)

Yes, I would like to participate (required)
---NSL Members $100Non Members $200

Method of Payment
---Check Credit

If paying by Check please make the check payable to:
the Newbury Street League

If paying by credit card, what type of card will you be using?
---American ExpressVisaMaster Card

Name on Credit Card

Credit Card #

Expiration Date

Description of your holiday stroll promotion:

Please enter the letters and numbers you see into the box below, to complete your participation form.