LEADS Interest Form

LEADS Interest Form
LEADS is dedicated to fostering a collaborative environment where professionals connect, grow, and succeed.

• Membership in the Chamber of Commerce is mandatory
• Groups meet weekly
• Each person exclusively represents their line of business/industry
• Company size does not matter
• Seats will be filled on a first-come, first-served basis
• Waiting lists will be maintained and openings filled as soon as possible
• Cost for participation is $150/year.
Name*

First NameLast Name
Title/Position*
Company*
Phone*
Email*
Please indicate the below if you have a particular LEADS group you are interested in
LEADS Group:*

Group 2Group 3Group 4Group 5Group 6Unsure
LEADS Group 2nd Choice:

Group 2Group 3Group 4Group 5Group 6
What type of industry is your business/organization?*

InsuranceReal Estate AgentAccountingAttorneyBankingMortgage ServicesMarketing/CommunicationsFinancial PlanningContractorNon-Profit OrganizationOther
If you answered "other" to the above question, please provide the type of industry your business/organization.
I understand if I am approved to join a LEADS group, I will be billed and required to submit payment before attending LEADS groups.
Name*

First NameLast Name
Initial here*
I agree to the above listed program guidelines
Statement Initialed on:*

MonthDayYear
Date
Should be Empty: