Xcell4Life Multiplex Center
Service Form
Member's Full Name
*
First Name
Last Name
Member's Phone Number
-
Area Code
Phone Number
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Which description below represents your use for the Xcell4life Multiplex Center
*
BUSINESS
PERSONAL
COMMUNITY
CORPORATE
Which service below are you interested in?
CHOOSE ONLY ONE
*
COMMUNITY MEMBERSHIP ONE DAY PASS $30
COMMUNITY MEMBERSHIP - MONTHLY $99
COMMUNITY MEMBERSHIP-ANNUALLY $999
OFFICE SPACE HOURLY $50 PER HOUR
OFFICE SPACE DAILY $200 DAILY
FACILITY RENTAL CONFERENCE ROOM $75 PER HOUR
FACILITY RENTAL CONFERENCE ROOM $250 DAILY
FACILITY RENTAL GRIND CAFE $100 PER HOUR, 2 HOUR MINIMUM
FACILITY RENTAL GRIND CAFE $300 DAILY
FACILITY RENTAL COMPUTER LAB $150 PER HOUR, 2 HOUR MINIMUM
FACILITY RENTAL COMPUTER LAB $400 DAILY
SIGN UP FOR A CLASS, TRAINING, OR WORKSHOP
BOOK A CONSULTING SESSION WITH DR. ANGELLA BANKS AND/OR TEAM
Would you like more information about the below topics? Choose one that best fits your current need
*
Leadership Development (Personal, Professional, Community)
Start A Business, Non-Profit or Ministry
Grow Your Business, Non-Profit or Ministry
Obtain Life, Business, Author, Speaker, Leadership Certifications
Obtain an Accredited Degree (Associates, Bachelors, Masters, PhD
ARE YOU READY TO BECOME A MEMBER OF THE XCELL4LIFE MULTIPLEX CENTER?
Yes
NO
If yes, please schedule an appointment to complete membership requirements.
Would you be interested in PARTNERING WITH ANY OF OUR GLOBAL PARTNERS, listed below?
*
Yes
No
If Yes, choose only (1) area of interest: Which is a top priority
*
Become a FREE Member of Xcellence, Inc.
Become a Student in Xcellence Leadership Institute
Become a Student in Strategic Growth Leaders University
Become a client or mentee of Dr. Angella Banks for business development, marketing, branding, consulting, coaching, or mentorship
Xcellence Community Magazine feature
Please provide any additional information:
Date Completed and Submitted
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Month
-
Day
Year
Date
Please allow 24-72 hours for membership application to be processed.
Please verify that you are human
*
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