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Basic Membership Registration Form
Join a exclusive global tech community of 1,500 professionals across 15 countries in a safe and moderated space.
14
Questions
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1
Name
*
This field is required.
First Name
Last Name
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2
Personal email
*
This field is required.
example@example.com
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3
Work email
example@example.com
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4
All States and Cities
*
This field is required.
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5
Mobile Number (for WhatsApp)
*
This field is required.
Will be used for WhatsApp invite. Please include your country code
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6
How many years of experience do you have in Tech?
*
This field is required.
0 (Student)
1-3
3-7
7-10
10+
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7
Job Title
*
This field is required.
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8
Company URL
*
This field is required.
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9
LinkedIn Profile URL
*
This field is required.
Required for security vetting
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10
Are you interested in investing in our community scale-ups? If so, how much typically (USD $):
*
This field is required.
I don't invest
0 to 10,000
1,000 to 10,000
10,000 to 50,000
50,000 to 100,000
100,000 to 250,000
250,000 to 500,000
500,000 to 1,000,000
1,000,000 to 5,000,000
5,000,000+
Other
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11
Are you able to host a JIT event at your office?
Yes, I am the right person to talk to
No
Yes
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12
Are you looking for investment now or in the near future?
No
Yes
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13
Is your team expanding right now?
No
Other
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14
Name and WhatsApp number of a current member who referred you or someone who can vouch for you.
*
This field is required.
Full Name
Whatsapp (plesae include international dialing prefix)
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15
Which membership option did you choose?
Please select the same membership option chosen during the Stripe checkout
Premium membership
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16
Permission for JIT to contact the customer
Yes
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