
BNI MINNESOTA & NORTHERN WISCONSIN   
Visitor and Substitute Sign-In
Date: ______________________
americas • europe • africa • asia • australasia
WWW.BNIMN.COM
WWW.BNIWIN.COM
Name: _________________________________________________________________
Company: _____________________________________________________________
Profession:  ____________________________________________________________
Address:  ______________________________________________________________
City/State/Zip: __________________________________________________________
Phone: ________________________________________________________________
Mobile: ________________________________________________________________
Email: _________________________________________________________________
  VISITOR 
Invited by: _______________________________________
 1st Visit   2nd Visit  Application Pending:    Yes   No
Current BNI Member:     
 Yes   No
Add Visitor to PALMS:     
 Yes   No
Send Visitor Follow-up Email: 
 Yes   No
  SUBSTITUTE
Subbing for:______________________________________
NOTES: _________________________________________
_________________________________________________
Name: _________________________________________________________________
Company: _____________________________________________________________
Profession:  ____________________________________________________________
Address:  ______________________________________________________________
City/State/Zip: __________________________________________________________
Phone: ________________________________________________________________
Mobile: ________________________________________________________________
Email: _________________________________________________________________
  VISITOR 
Invited by: _______________________________________
 1st Visit   2nd Visit  Application Pending:    Yes   No
Current BNI Member:     
 Yes   No
Add Visitor to PALMS:     
 Yes   No
Send Visitor Follow-up Email: 
 Yes   No
  SUBSTITUTE
Subbing for:______________________________________
NOTES: _________________________________________
_________________________________________________
Name: _________________________________________________________________
Company: _____________________________________________________________
Profession:  ____________________________________________________________
Address:  ______________________________________________________________
City/State/Zip: __________________________________________________________
Phone: ________________________________________________________________
Mobile: ________________________________________________________________
Email: _________________________________________________________________
  VISITOR 
Invited by: _______________________________________
 1st Visit   2nd Visit  Application Pending:    Yes   No
Current BNI Member:     
 Yes   No
Add Visitor to PALMS:     
 Yes   No
Send Visitor Follow-up Email: 
 Yes   No
  SUBSTITUTE
Subbing for:______________________________________
NOTES: _________________________________________
_________________________________________________
Name: _________________________________________________________________
Company: _____________________________________________________________
Profession:  ____________________________________________________________
Address:  ______________________________________________________________
City/State/Zip: __________________________________________________________
Phone: ________________________________________________________________
Mobile: ________________________________________________________________
Email: _________________________________________________________________
  VISITOR 
Invited by: _______________________________________
 1st Visit   2nd Visit  Application Pending:    Yes   No
Current BNI Member:     
 Yes   No
Add Visitor to PALMS:     
 Yes   No
Send Visitor Follow-up Email: 
 Yes   No
  SUBSTITUTE
Subbing for:______________________________________
NOTES: _________________________________________
_________________________________________________
REV. 06.01.2015