Please fill out the form below to get started "*" indicates required fields Name* First Last Email* Phone*Business Name* Industry Applying For* Experience* Length of time in your Industry/ProfessionWho Invited You to the Group?* GROUP RESPONSIBILITIESAre you willing and able to make the commitment to arrive at the weekly meetings on time and stay until the end of the meeting?* Yes No Are you willing and able to send a substitute if you are unable to attend a meeting?* Yes No Are you willing and able to bring referrals and/or visitors to this group?* Yes No Can you pay the annual membership fee of $300?* Yes No Do you belong to other networking organizations?* Yes No If you answered yes, please list below which organization.* REFERENCESPlease list two character references below.REFERRAL #1Name* First Last Phone*Email* Business* How do you know them?* REFERRAL #2Name* First Last Phone*Email* Business* How do you know them?* CommentsThis field is for validation purposes and should be left unchanged. Δ
