New Member Form APPLICATION FORM CLICK HERE TO VIEW MEMBERSHIP STRUCTURE PLEASE FILL OUT THE APPLICATION BELOW Purchasing Members’ Full Name First Name Last Name Where Did You Get Your Invitation COMPANY INFORMATION Company Name Position Address Address 1 Address 2 City State/Province Zip/Postal Code Country SOCIAL PROFILES Facebook Linkedin EXECUTIVE ASSISTANT (IF ANY) Executive Assistant Name Executive Assistant Email Executive Assistant Telephone Country (###) ### #### All information received is kept strictly confidential, it will not be shared with any third-parties, and is solely used for membership approval for Après Noir IF YOU ARE PURCHASING A MEMBERSHIP BEYOND 2 FULL TABLE (10 MEMBERS), PLEASE CONTACT MEMBERSHIP@APRESNOIR.COM FOR APPLICATION. Preferred Method Of Contact * Executive Assistant Personal Membership Type * Please select one Quarterly (First 3 Events) Platinum – 3rd Tier Seating (Includes Champagne) $4,275 ($1,425 per show) Quarterly (First 3 Events) Executive – 2nd Tier Seating (Includes Moët & Chandon) $5,700 ($1,900 per show) Quarterly (First 3 Events) Elite – 1st Tier Seating (Includes Caviar & Dom Perignon, Served By Personal Butler) $7,125 ($2,375 per show) Semi Annual (Choice Of 6 Events) Platinum – 3rd Tier Seating (Includes Champagne) $8,100 ($1,350 per show) Semi Annual (Choice Of 6 Events) Executive – 2nd Tier Seating (Includes Moët & Chandon) $10,800 ($1,800 per show) Semi Annual (Choice Of 6 Events) Elite – 1st Tier Seating (Includes Caviar & Dom Perignon, Served By Personal Butler) $13,500 ($2,250 per show) Annual (All 12 Events) Platinum – 3rd Tier Seating (Includes Champagne) $15,300 ($1,275 per show) Annual (All 12 Events) Executive – 2nd Tier Seating (Includes Moët & Chandon) $20,400 ($1,700 per show) Annual (All 12 Events) Elite – 1st Tier Seating (Includes Caviar & Dom Perignon, Served By Personal Butler) $25,500 ($2,125 per show) Number Of Memberships * 12345678910 CREDIT CARD INFORMATION I agree to pay the one-time fee for my chosen Membership Type selected above. * Visa Amex Mastercard Credit Card Number * Expiry Date * CVV * Name As It Appears On Card * All applicants are screened and vetted by Schwartz Levitsky Feldman LLP. I agree that if my application is approved, I will adhere to all official membership rules and regulations. I understand that my credit card will NOT be used beyond this membership fee. I authorize Après Noir, Inc., division of Chateau Le Jardin Event Venue to charge my credit card for the above noted Membership Fee. Thank you! Download The Membership Pre-Guide CLICK HERE TO DOWNLOAD
