First Name *

Last Name *

Email *

Phone *

Title *

Organization *

Business Industry/Specialty *

Please be as specific as possible; e.g., commercial real estate vs. residential, medical insurance vs. P&C

Are you a current member of Greater Fort Wayne Inc? *

GFW Inc. Leads Groups are open to active GFW Inc. Members only. Individuals may not be voted into/remain in a Leads Group as a participant if their company is not an active GFW Inc. Member company.

Address Line 1

Address Line 2

City

State

Postal Code

Referral

Were you referred or invited to a Leads Group by a current participant? Please list their Full Name, Email, and Company here:

Please select the group you would like to visit. *

Enter required value B2B Professionals - WAITLISTED-- Meeting Time 7:45 -9:00AM on 1st & 3rd Wednesdays @ GFW Inc Commercial Leads Exchange- Meeting Time 7:45 -9:00AM on 2nd & 4th Thursdays @ GFW Inc Leads-R-Us - Meeting Time 12 -1:30PM on 1st & 3rd Tuesdays @ Salvatori's Southwest Business Enthusiasts Exchanging Referrals (B.E.E.R.) - Meeting Time 2nd & 4th Tuesdays, various times & locations Maintaining Fort Wayne - Meeting Time 8:00 -9:00AM on 2nd Wednesdays @ GFW Inc, 12PM on 4th Wednesdays, location varies Connector's Edge- Meeting Time 8:30 -9:30AM on 2nd & 4th Thursdays @ Hunsche CPA Group Fort Wayne Independent - Meeting Time 8:00 -9:30AM on 1st & 3rd Thursdays @ GFW Inc

Agreement to Policies and Procedures *

I have read and agree to the GFW Inc. Leads Group Policies and Procedures document and understand that I am permitted to visit a maximum of TWO (2) separate meetings between all active leads groups with an opening for my specialty/category in the billing year (January to December) before vote is required for official membership in that group. I understand GFW Inc. staff will strictly enforce that I CANNOT visit/join any Leads Group where the policies or procedures are not followed.

Do you need any accommodations to participate in a Leads Group?

Digital Signature *

Please type your name indicating everything submitted on this application is true.