Chamber Peer Connections Group Intake Form

Peer Connections Group Intake Form

Peer Connection Groups bring together Chamber members in similar roles or organizations for meaningful connections, shared learning, and honest conversation. These small, facilitator-led groups create a trusted space to learn from and support your peers. Complete the form below to apply, and our team will follow up with next steps. All personal information submitted will be treated with discretion and confidentiality.
Name

First NameLast Name
Email
example@example.com
Phone Number

Area CodePhone Number
Company Name
Industry
Job Title
Which Peer Connection Group(s) are you interested in joining?

Other
Peer Connection Groups are dependent on someone willing to facilitate the group. We aren't asking you to be an expert on everything - we are asking you to set the tone for the group, organize meetings, and be the liaison with the Chamber. Would you be willing to facilitate for your group?
Peer Connection Groups meet monthly for approximately one hour, typically during the workday. Meeting dates and times are determined by each group’s facilitator. Can you commit to making time for these monthly meetings from September through June once your group’s schedule is established?
By filling out this form, you understand that Peer Connection Group Members must be members of the West Coast Chamber and commit to fully attending meetings. Members are expected to be respectful to fellow group members and build trusted relationships with one another.
I agree that the Chamber will share my contact information with my Peer Connection Group facilitator and fellow group members for group communication and planning purposes only. My information will be shared with discretion and treated confidentially.
Please upload your preferred headshot. This will not be shared externally - just with your group members.

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