EmailMe Form - Network ONE - Membership Application

Basic Information

Today's Date *

MM / DD / YYYY

Which CITY / AREA are you interested in? *

Which GROUP would you like to join? (Chalmette Groups) *

Choose one of the groups listed, so that your application can be routed to the correct person. If there are NO groups in CHALMETTE, or there are no openings for your classification in any of the current groups, please mark A NEW GROUP IN CHALMETTE, and we'll contact you if a position opens either in an existing group or new group.

Which GROUP would you like to join? (Covington / Mandeville Groups) *

Choose one of the groups listed, so that your application can be routed to the correct person. If there are NO groups in COVINGTON / MANDEVILLE, or there are no openings for your classification in any of the current groups, please mark A NEW GROUP IN COVINGTON / MANDEVILLE, and we'll contact you if a position opens either in an existing group or new group.

Which GROUP would you like to join? (Hammond Groups) *

Choose one of the groups listed, so that your application can be routed to the correct person. If there are NO groups in HAMMOND, or there are no openings for your classification in any of the current groups, please mark A NEW GROUP IN HAMMOND, and we'll contact you if a position opens either in an existing group or new group.

Which GROUP would you like to join? (Picayune Groups) *

Choose one of the groups listed, so that your application can be routed to the correct person. If there are no openings for your classification in any of the current groups, please mark A NEW GROUP IN PICAYUNE, and we'll contact you if a position opens either in an existing group or new group.

Which GROUP would you like to join? (Slidell Groups) *

Choose one of the groups listed, so that your application can be routed to the correct person. If there are no openings for your classification in any of the current groups, please mark A NEW GROUP IN SLIDELL, and we'll contact you if a position opens either in an existing group or new group.

How Did You Hear About Network One? *

Tell us how you heard about Network One: Google, Social Media, Personal Invite, etc...

Who is Your Sponsor?

If no current member has offered to be your sponsor, please leave this field blank.

Your Name *

First Last

Should be the Name of the person who will be attending each week, not just the owner.

Upload Your Photo or Headshot *

We need a photo of you for our website. We crop the picture to just include your head. File should be in PNG or JPEG format. 10 Mb limit to file size.

What size shirt do you wear? *

For when we order shirts for our members.

Your Business Name *

Your Business Category *

Because only ONE business from each particular category is represented, we need to know your category to check for overlaps with current members.

Business Address *

Street Address City State / Province / Region Postal / Zip Code

Business Website

Business Phone *

### - ### - ####

Your Mobile Phone *

### - ### - ####

Your Email *

Your Experience

Feel free to attach a RESUME or brief biography for additional information. (PDF format preferred)

Upload your Resume or Biography

Not required, but PDF or DOC formats only. 10 Mb limit to file size.

What sort of experience do you have in your profession? *

Please be specific.

Your Job Title *

Length of Time in Your Business? *

List Education / Degrees or Professional Credentials *

Is this Business your primary occupation? *

If NO, please explain in the "Explanation" field.

Explanation

Membership Expectations

Are you able to attend WEEKLY meetings, arrive on time, and stay for the entre 90 minutes? *

Are you able to send a SUBSTITUTE if you are unable to attend a meeting? *

Are you committed to bringing REFERRALS and helping us grow your group? *

Are you a member of any other business networking groups? *

If YES, please list them.

Other Networking Groups

Membership Agreement

(Please READ and then SIGN below). I AGREE that by participating in a Network One business networking & referrals group, I will abide by and live up to all rules, regulations and objectives of this organization / group. I hereby agree to fulfill my obligations of: paying annual dues, attending meetings, and helping my fellow member’s businesses grow, as I grow my own. I realize my commitment to participating in this group is a privilege and is an integral part of the group’s success.

I understand that Network ONE is governed by the Executive Board of Directors.

I understand that LEADS and/or REFERRALS given or received are privileged information and will remain “Confidential” between the giving and receiving parties.

In the event that I am unable to fulfill my obligations to this group, as defined by the group guidelines, I agree to voluntarily withdraw my membership.

Your Signature *

Clear

Sign with your finger or computer mouse.