Networking Austin  
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Networking Austin
Part I - Contact Information
First Name
Last Name
Home Address
City Zip
Date of Birth
Business Name
Title
Business Address
City Zip
Business Phone
Cell Phone
Fax
Email
Business Website
Part II - Business Information
Which club would you prefer to attend?  
Describe products, services and top areas of expertise:
Is the business under which you are applying for membership full time or part time? Part time
How long have you been in this business / profession / occupation?
How long have you lived or worked in the Austin area?
What degrees, certifications, designations, licenses, or other credentials do you have, either in or outside of your current business/profession/occupation?
Part III - Business & Personal References
Name Position
Business Phone Fax
Name Position
Business Phone Fax
Name Position
Business Phone Fax
Part IV - Rules
Cancellation
Membership may be cancelled by written notice, with effective termination being the last day of the month in which cancellation notice is received. Member is
responsible for dues up to and including effective date of termination, and one additional month unless the annual contract date has been reached.
I have read, understand, and will adhere to expectations, code of ethics & rules of participation which may be modified from time to time by Networking Austin.

 
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