Executive Membership Nomination

Executive Membership Nomination Form

Nominate yourself or someone on your team or in your network below who meets The Fourth Effect's requirements for a year of free Executive Membership ($711.00).

*Executive Membership in The Fourth Effect is designed for executives and entrepreneurs ready for Board Advisor and governing board roles who hold a leadership role within their organization with an established career and ≥10 years of professional experience. Executive Members who also qualify as an accredited investor under Title 17 of Regulation D are welcome to join our private investment club as an angel, LP or GP any time. Within the first 30 days of membership all new members are reviewed independently and we reserve the right to remove membership selections (and reimburse any correlating membership fees) if members are determined to not meet membership criteria.

Your Name

First NameLast Name

Your Company

Nominee

First NameLast Name

Nominee Linkedin*

Nominee Email*

Your Relationship to Nominee