The Powerhouse Table
Registration of Interest
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Business/Brand Name
*
Instagram Handle
*
What industry are you in?
What stage is your business at?
Please Select
Just starting out
Growing and scaling
Established and thriving
Exploring my next chapter
Other
What inspired you to want to join this lunch?
What type of women or collaborations are you most interested in connecting with?
What would make this lunch feel like a "wow" experience for you?
One word to describe the energy you're bringing to the table?
Do you have any dietary requirements?
Would you like to be notified about future lunches, networking events, or retreats?
Please Select
Yes
No
If we share event photos or highlights, are you comfortable being tagged?
Please Select
Yes
No
Submit
Should be Empty: