New Member Application


Date

Title

Name

Your Email (required)

Phone

Cell Phone Number

Company Name

Street Address (required)

Street Address Line 2

City

State / Province

Postal / Zip Code

Country :

Web Site URL

Who Referred You to SDBR?

What is your Professional
Classification? e.g. Attorney, CPA,
Banker

Describe your professional
background

How many years have you been
in your industry or profession?

How many years in San Diego?

How many years with your current
organization?

How long has your current
organization been in business?

If licensed or credentialed, are you
current and in good standing?

Do you have a niche or specialty?

Are there specific industries that
you serve?

What are your competitive
advantages?

Please describe a typical client?
(Revenue, Industry, Services
Provided)

Please list any professional or
industry associations you
belong to?

Please list any service or
networking groups you
belong to?

Would you consider yourself a
Connector, Referral Source or
both? (Please describe why?)

As a member, what would you like
to contribute to other members?

Describe the last two referrals you
made and how you made them.

Describe the last two referrals
made to you

Describe any relevant education
and certifications you have that
differentiate you amongst your
peers.

Describe your hobbies/special
interests

Describe why your last client hired
you.

Will you be able to make a
commitment to attend
meetings?

Please list any other networking
organizations that you belong to:

Your Message

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