Membership Application for The Men’s Group

Please complete the following information to be considered for placement in the Men’s Group.

I am:

A Business Owner

A Professional (leader or key contributor who does not have ownership in their company.)

Name

First Name

Last Name

Title

Business Name

Email Address

Business Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Cell Phone

(###)

###

####

Business Phone

(###)

###

####

Describe your business/company:

What you do, when you started your business or started with your company, who your customers are.

Share your Personal Goals:

What goals do you have for your business/company, leadership skills, life.

What are the top 3 things you would like to gain from your Group experience?

What unique skills/experience will you bring to the Group?

What days and times of day are best for you to meet if you were in a Group?

We have Groups that meet throughout the metro area. Is there a geographical location that you CAN NOT do?

How did you hear about us?

Anything else we need to know?

If you have a specific question, Circle you are applying for, etc. please note that here.

FOR Business Owners only

Please provide the following additional information. We will use this data when determining Circle placement.

Gross Annual Revenue

Years in Business

Number of Employees (if applicable)

Not counting self.

Thank you.

If you have any questions, please contact us at 612-208-2842.

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