Moonshot Membership Application
Apply to become a member of Moonshot by completing the form below. Please provide accurate and complete information to help us validate your identity. We will reach out to you via email if your application is approved. Community (general) membership is $99/year. Reach out directly for Coterie (patron) membership.
Email Address
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LinkedIn, Instagram, or URL Verification
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First Name
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Last Name
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Current Company
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Current Title or Position
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List Sport(s) You're Involved in
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Industry in Sport
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Please Select
Business & Finance
Education
Healthcare
Technology
Industrial & Manufacturing
Consumer & Retail
Legal Services
Media & Entertainment
Energy & Environment
Transportation & Logistics
Public & Social Sector
Hospitality & Real Estate
Closest City
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Please Select
New York City
Washington DC
Chicago
Dallas
Los Angeles
Why you'd like to become a member
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Do you agree to help lead one event per year?
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Please Select
Yes
No
How did you hear about Moonshot Membership?
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Please Select
Social Media
LinkedIn
Friend Referral
Other
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Submit Application
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