*1.First and Last Name(Required.)

*2.Email(Required.)

*3.Phone Number(Required.)

4.Referred By

*5.Company Name(Required.)

*6.Job Title/ Role(Required.)

*7.Years in Business(Required.)

*8.Number of Employees(Required.)

*9.Past 3 Years of Revenue(Required.)

*10.Do you have any experience with EOS?(Required.)

Yes

No

11.If yes, how many years of experience do you have with EOS? 

12.If yes, who is your EOS Implementer?

13.Social Media Profiles

*14.Why are you interested in becoming a member of the BAR? (Required.)

*15.What specific expertise or experience do you bring to the roundtable discussions? Please provide a brief overview. (Required.)

*16.What challenges or opportunities are you currently facing?(Required.)

*17.What areas of your business are strongest?(Required.)

*18.How do you think participating in the roundtable will help address #16 and amplify #17?(Required.)

*19.Describe a recent accomplishment or project you have been involved in that highlights your skills and expertise: (Required.)

*20.Are there any particular topics or areas of interest you would like to explore, learn more about or discuss during our sessions?(Required.)

*21.What qualities or attributes do you believe make for effective and collaborative roundtable discussions? (Required.)

*22.Have you participated in any other roundtable or networking events in the past? If yes, please briefly describe your experience.(Required.)

*23.Will you commit the time and frequency required to create value from participating in the roundtable sessions? (Monthly online sessions ~ 3 hours each as well as 3 in person meetings) (Required.)

Yes

No

*24.How did you learn about our roundtable and what motivated you to apply? (Required.)

*25.What are you looking to gain by participating in the BAR? (Required.)

*26.What must be true a year from now – in your business, as a leader and in your life – to consider your participation a success?(Required.)

*27.Is there anything else you would like us to know about you or any additional comments you would like to share? (Required.)