Membership Application Form

i would like to be considered for Membership in a connect the dots collective circle

To apply for membership, please complete all questions.
This is a category exclusive group for women business owners organized in small circles of no more than 12 women.

Should a spot in your category be open in a current Circle, and your membership application meets our membership criteria, you will be contacted for the next steps which includes a membersip interview. Please note that not every membership application will be accepted.

Membership is by invitation only and covers a period of one calendar year.

Direct Sales and Coaching are considered to be their own category - regardless of product or coaching type.

Renewal for the next year is predicated on the level of engagement in your current Circle.

The mix of members within a specific Circle is of paramount importance to make sure that everyone gains in the experience of growth. Not every business category will be added to every Circle.

New Circles will be opened when a specific geographic area or mix of participants is deemed optimal .

A full listing of the Connect The Dots Collective Guiding Principals is found HERE

Submitting this form for membership consideration is an acknowledgement of all requirements and shows the understanding of our Guiding Principals.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
example@example.com
Preferred Phone Number*
Business Name*
If you are a Board Certified Professional (a Fiduciary Financial Professional, a Healthcare Professional, etc.), please provide the name of the state or federal licensing Board that holds your certification and the name under which you are currently registered/practicing.
How long have you been active in your business?*
If you are a Sales Professional representing a larger firm, please provide the name of the company you represent
Please provide a brief description of your business.*
What you are hoping to find in this group?*
What has NOT worked for you in other groups?*
What skills/abilities do you bring to the group?*
Should be Empty:

i would like to be considered for Membership in a connect the dots collective circle