Form

CONTACT INFORMATION

Applicant Name *

Group

Business Name *

Sponsor

Business Address *

Business Category

City / State / ZIP *

Website

Email *

Business Phone *

Mobile Phone

PROFESSIONAL EXPERIENCE

Job Title *

Years in Profession

Years in Business

Is this your Primary Occupation?
YesNo

If not primary, describe

Other Networking Groups (past or present)

MEMBERSHIP EXPECTATIONS

By initialing each item below, you acknowledge and agree to each expectation.

Attend weekly meetings, arrive on time, and remain for the full meeting.

Initials *

Send a qualified substitute when unable to attend a scheduled meeting.

Initials *

Provide referrals to other members and follow up promptly on referrals received.

Initials *

Keep member leads and referrals confidential unless permission is given to share.

Initials *

DUES

Network ONE Dues
$100 per year (due in January)

Group Dues Amount

Group Dues Frequency

Group Dues Due Date

MEMBERSHIP AGREEMENT

I agree that, by participating in Network ONE, I will abide by the rules, regulations, and objectives of the organization and my individual group. I understand that membership includes the obligation to attend meetings, pay applicable annual and group dues, support fellow members, provide referrals when appropriate, and follow up professionally on referrals received. I understand that leads and referrals shared within the group are privileged business information and should remain confidential between the giving and receiving parties unless permission is granted to share. I understand that Network ONE is governed by its Executive Board of Directors and that failure to fulfill membership obligations may result in voluntary withdrawal or review under the organization's bylaws and guidelines.

Full Name (as Signature) *

Date *

I have read and agree to the Network ONE Membership Agreement above. *

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