Inner Circle Membership Application
Complete the application with your personal, business, and leadership details to be considered for membership.
Personal Information
Full Name
*
First Name
Last Name
Preferred Name
*
Birthday
*
-
Month
-
Day
Year
Date
Email Address
*
example@example.com
Mobile Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
City and State
*
LinkedIn Profile or Website
*
How did you hear about the Inner Circle?
*
Were you referred by a current member? If so, by whom?
*
Company Information
Company Name
*
Your Title or Position
*
Company Website
*
Industry
*
How long have you been in business? If less than 2 years, what was your previous work?
*
How long have you been in your current position?
*
Number of employees or team members you lead
*
Primary geographic market or service area
*
What products, services, programs, or experiences does your company offer?
*
Who is your primary customer audience or avatar?
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What stage best describes your business today?
*
Emerging or early-stage
Growing
Established
Expanding into new markets
Preparing for succession or sale
Reinventing or repositioning
Other
Business and Leadership
What is one of your greatest strengths as a leader?
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Second strength
*
Third strength
*
What leadership area are you currently working on strengthening?
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What is the greatest growth opportunity in front of your business during the next 12 to 24 months?
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What is the greatest challenge, obstacle, or decision you are currently facing?
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Please share an accomplishment you are especially proud of and why it matters to you.
*
Inner Circle Participation
Why would you like to be involved in the Inner Circle?
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What topics would you most value learning about?
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Leadership
Business growth
Culture and team development
Communication
Negotiation
Marketing and branding
Sales
Wealth creation and management
Financial strategy
Health and well-being
Relationships
Mindset and personal growth
Succession planning
Legacy and significance
Emerging technologies
Other
Contribution and Collaboration
The strength of the Inner Circle will be determined by the quality of the people in the room and their willingness to contribute, listen, serve, and share.
Are you willing to share ideas, resources, introductions, and experiences when doing so could add value to another member?
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Yes
No
It depends on the circumstances.
Getting to Know You
What are you most passionate about outside of your business?
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Who are some leaders that have had the greatest influence on your leadership?
*
Final Question
Is there anything else you would like us to know as we consider your application?
*
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