New Member Application Form

The purpose of WIN4 is to support and assist each other in our sales and business development. We never compete with each other. Each member is allowed to represent only one service or product within WIN4. Therefore, the category of membership to which you apply is the only business, service or product that you can promote within the group.

You must attend two (2) meetings before you may apply for membership.

Please note that the non-refundable application fee is $25.

Your Name(required)

Company Name(required)

Company Website

Work Address(required)

Email(required)

Work Phone Number

Cell Phone Number

Which category of business do you wish to represent ?(required)

In what other networking groups are you a member?(required)

Birthday

Please describe your service/product/business as fully as possible.(required)

Describe your involvement in the community, board of directors, etc.(required)

How did you hear about us?(required)

If you heard about WIN4 from a current or past member, please indicate their name below.

Note: A $25 Membership Application Fee must accompany your application. Once your application is received, the Membership Chair will contact you regarding the fee. This fee is non-refundable. Once accepted into WIN4, the annual dues are $75.00. A pro-rata amount for annual dues will be charged to new members who join mid-year.