StratX Ottawa 2026-2027 Membership Application
Applicant Information
Full Name
*
First Name
Middle Name
Last Name
Birthday
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Street Address
*
Street Address Line 2
City
*
State / Province
*
Postal / Zip Code
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Professional Information
Are you a Founder or Executive?
*
Founder
Executive
Both
Other
Organization/Company
*
Industry
*
Please Select
Technology
Healthcare
Finance
Education
Retail
Manufacturing
Real Estate
Nonprofit
Government
Other
LinkedIn Address
Interests & Engagement
What topics are you most interested in exploring?
Would you be willing to serve as a mentor within the group?
Yes
No
Maybe
Would you be interested in being paired with a mentor (mentee role)?
Yes
No
Maybe
What do you hope to gain from StratX Ottawa this year?
Do you have a specific ask — something you would like support with?
What strengths, experiences, or knowledge can you contribute to the group?
Accessibility & Logistics
Accessibility needs, dietary restrictions, or considerations for in-person sessions
Anything else we should know to make this experience meaningful and valuable for you?
Payment & Agreement
Payment Preference
*
Pay in Full
Installments
Need Assistance
Other
Program Participation Understanding and Agreement
*
I understand the membership commitment and participation expectations
I agree to follow program policies and community guidelines
I acknowledge that payment preferences do not guarantee acceptance
Other
Meeting Time Preferences
Preferred Meeting Time – First Choice
*
Please Select
Early Morning
Noon (11:30am–1:30pm)
Evening (5:30pm–7:30pm)
Preferred Meeting Time – Second Choice
*
Please Select
Early Morning
Noon (11:30am–1:30pm)
Evening (5:30pm–7:30pm)
Preferred Meeting Time – Third Choice
*
Please Select
Early Morning
Noon (11:30am–1:30pm)
Evening (5:30pm–7:30pm)
Submit
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