1- Contact Information
First Name
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Last Name
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Phone
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Email
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Company
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2- Primary Residence (City, State):
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3- Secondary Residence (if applicable):
4- Please provide a brief overview of your company, its operations, and market presence:
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5- Business Ownership & Affiliations:
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Business Owner/Founder
C-Level Executive (CEO, CFO, etc.)
Investor/VC/PE Partner
Other (Please Specify)
Please Specify
6- What are your key professional interests and goals in joining The Maverick Club?
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Dedicated Executive Office Space
Investment & Deal Flow Opportunities
Business Growth & Networking
Social & Lifestyle Benefits
Conference Rooms/ Meeting Spaces
Other
7- Do you have any notable business affiliations, board memberships, or advisory roles?
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Yes (Please Specify)
No
Please Specify
8- How often do you anticipate utilizing The Maverick Club’s space and resources?
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Weekly
Bi-Weekly
Monthly
9- Are there any current members who have referred you?
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Yes (Please Specify)
No
Please Specify
10- Have you ever been subject to any legal, financial, or professional disputes that may impact your membership eligibility?
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Yes (Please Specify)
No
Please Specify
11- If you choose to move forward with a membership application, do you consent to a confidential background verification process, which includes a credit history review, verification of business affiliations, and a criminal background check?
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Yes
No