Membership Application

Applicant Name *

Business Name *

Business Address *

Business Phone *

Mobile Phone *

Business Email *

Business Website *

Google Business Profile Review URL *

Date of birth *

Relevant Social Media Links *

How did you hear about us? *

Please select the Chapter you wish to join (more Chapters coming soon!): *

Quandary ( Every Monday from 1:00 - 2:00PM @ North Horizons Credit Union (Top Floor) 13559 Huron Street Westminster, CO 80234)

Mount Massive ( Every Tuesday from 12:30 - 1:30PM @ Ramos Law 10190 Bannock St #200 Northglenn, CO 80260)

Longs Peak ( Every Wednesday from 2:00 - 3:00PM @ Horizons North Credit Union 13559 Huron Street, Westminster, CO 80234)

General Waitlist (Choose this if you're open to joining any Chapter as spots become available)

Pikes Peak ( Every Monday from 2:00 - 3:00PM Online)

Are you open to being placed on a waitlist if your preferred Chapter is currently full? *

Yes, I am open to being waitlisted.

No, I prefer to join a Chapter immediately.

EXPERIENCE

Type of Business *

Years in Business *

Experience *

PROFESSIONAL GOALS

Immediate and Long-Term Goals for Your Business *

What Unique Skills Do You Bring to the Group? *

What is Your Objective for Leads Group Participation? *

EXPECTATIONS

Can you commit to our scheduled meeting times for the duration of the meeting: *

Yes

Can you commit to outside activities to develop relationships with the group members? *

Yes

Are you willing to bring referrals and guests to this chapter? *

Yes

Are you willing to plan a networking event for this group once a year? *

Yes

Do you belong to any other networking groups? If so, please list. *

Yes

List your other networking groups *

Please attach your headshot for our Member Directory: *

Please include your BIO for the Member Directory: *