Membership Request Form

Thank you for showing interest in our membership programs! We are excited to learn more about you. Please review the membership packages and fill out the form below to begin the application process and schedule your interview.

If you have already been interviewed please upload a headshot photo (of high resolution quality).

FULL NAME *

Prefix First Name Last Name

BUSINESS NAME:

WEBSITE

PHONE NUMBER *

Area Code Phone Number

E-MAIL *

What state or country is your business located?

What membership/ network are you inquiring about?

Have you already been interviewed?

Are you a speaker or coach?

Speaker Only: What topics do you speak on?

What products or services do you offer?

Coaches Only: What areas do you provide coaching?

What challenges do you face in your business?

What Social Media platforms can we connect with you?(please include the links)

Do you want to be entered into the Business Directory?

Do you want to be entered into our Coaching Network? (As part of the coaching network you agreed to be paid $50 for 30 minute of coaching for any member of the organization that goes through hour link on the website to book your services.)

Coaching Network: If you stated "YES" to the previous question above then please lists the days and time you are avail for coaching during the week or on weekends.

Who referred you?

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Membership Packages

Global Women In Leadership- Pay In Full $ 650.00

Virtual Speaking Platforms Live Speaking Platforms Virtual Interviews BWH Coaching Network Annual Summit Live Platform Annual Tour Live Platform Monthly Newsletter Entry Highlight Business Online Entry into All Events 1 Minute Business Video Presentation Promo, Entry into the Business Directory, Marketing Material * minimum of 5 events per monthly

Global Women In Leadership- 4 Installment Payments $ 162.50

Virtual Speaking Platforms Live Speaking Platforms Virtual Interviews BWH Coaching Network Annual Summit Live Platform Annual Tour Live Platform Monthly Newsletter Entry Highlight Business Online Entry into All Events 1 Minute Business Video Presentation Promo, Entry into the Business Directory, Marketing Material * minimum of 5 events per monthly

Global Women In Network Free

Free Annually Post Businesses In Network Access to Affordable Coaches Entry into Virtual & Live Events Network & Collaborate w/ CEOs Entry into Business Directory Facebook Groups -Posting

Total $ 0.00

Payment Methods

Debit or Credit Card

First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please click one of the PayPal options to complete payment and submit the form.