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* 1. Your name:

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* 2. Your email address:

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* 3. Are you the CEO/President/Chairman or Chief Decision-maker of your organization?

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* 4. What is the name of your organization? 

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* 5. Based on your experience at the CEO Brand Catalyst Partners Summit, how likely are you to recommend others attend future events?

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* 6. What is your level of interest in joining the BCP Catalyst Club?

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* 7. What are your biggest needs as an organization? (check all that apply)

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* 8. Please provide any other thoughts about the BCP Catalyst Club or the Summit Experience:

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