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Business Referral Network Application
BRN Group:
Chair of Group:
First Name:
Last Name:
Phone Number:

Fax Number:
E-Mail:
Website:
Company Name:
Address:
City:
Zip:
Nature of Business:

The San Jose Silicon Valley Chamber of Commerce Business Referral Network referrals are conditioned on your agreement to release and forever discharge the San Jose Silicon Valley Chamber of Commerce and its Business Referral Network Groups from any and all liability, known or unknown, arising out of the referral and any advice or information received in the course thereof. Your contact of any of the referrals will be considered an acknowledgement by you of your understanding and consent to this release, and your agreement to its terms. Be advised that you might be relinquishing legal rights by agreeing to this release.

Submit:
Please print this page for a receipt before you submit.

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San Jose is the largest city in the Bay Area, located roughly 50 miles south of San Francisco and 390 miles north of Los Angeles.



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