Nonprofit Executive Mastermind Group
Interest Form

Question Title

* 1. Contact Info

Name

Title

Organization

Email

Phone

Question Title

* 2. How long have you been in your position?

<1 years

1-2 years

3-5 years

6-10 years

11-15 years

15+ years

Question Title

* 3. Number of employees in organization

1-5

6-10

11-25

26-50

51-99

100+

Question Title

* 4. Why do you want to be a part of a Mastermind group? What are the top three goals you want to achieve by being a member?

Question Title

* 5. How did you learn about this opportunity?

LinkedIn

Facebook

Networking Event

Email Newsletter

Word of Mouth

Nonprofit NetWalk

Other

Question Title

* 6. What topics would you like our group to address over the course of the next six months? (rank each topic in order from most to least interest)