CEO ConneX Payment Form

CEO PRO Member Form

Please fill in requested information and then use link to make payment
Name as it appears on CEO ConneX Member Profile if different from above
Your Name

First NameLast Name
Your Email (will not be publicly listed)
example@example.com
Your Phone Number (will not be publicly listed)
Business Listing Information

Please provide information about your business to be used in your CEO listing on our interactive map
Business Name
Your Professional Title(s)*
Business Email (will be Visible)
Short Business BIO to add to Listing (no more than two short paragraphs)*
Website URL*
Select if Business is Online, Brick & Mortar, or BOTH

OnlineBrick & MortarBOTH
Business Address (if no physical location, provide the City/Country you reside in)
Upload Headshot Image to Use for Listing *

Cancelof
Upload Business Logo

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Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

My Products*

CEO PRO Annual Membership ($97 Best Option for Small Business) Product Image

CEO PRO Annual Membership ($97 Best Option for Small Business)Includes all membership benefits as outlined on the website's sign-up page. Upon receipt of payment, you will receive a confirmation email acknowledging your approval within 24 business hours. Your listing will become visible, and access to private spaces will be granted within 48 business hours. Please note business hours DO NOT include Saturday, or Sunday. Please email connect@ceoconnexnetwork.com with any additional questions or concerns.

$97.00 for each year

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CEO PRO Member Form

Business Listing Information