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Peer to Peer Application
Please complete this profile form so we can learn more about you and your business, and place you appropriately.
First Name
Company
Address
State
Email
Phone
How long have you been with the company?
Your position/role
CEO/President/GM
CFO
OTHER
OWNER
VP
Do you understand that being a member of a peer group requires mandatory meeting attendance and strict confidentiality within the group?
Choose one:
No
Yes
Last Name
Certification Designation
City
Zip Code
Website
Cell Phone
If you were referred by someone, please list name:
What do you hope to gain from the peer group experience?
How do you think you can contribute to the group?
Do you have any questions?
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