Request edit access
Founding Member Assessment
The House of Influence Founding Membership is reserved for visionary women who want to expand their global footprint, connect with influential peers, and be part of a 360° ecosystem that lasts beyond a single event.
We have 20 founding member spots available. This short assessment will help us see if this is the right fit for you — and help you see the unique advantages of being part of it.
Name *
Email *
LinkedIn / WebsiteEmail *

Where are you based? (City / Country)

 *
1 point

What is your main profession, business, or area of expertise?

 *
1 point

Your Current Stage

Which of these best describes you right now? (Choose one)

 *
1 point
Required

Your Network & Influence

How would you describe your current professional network?

 *
1 point
Required

Why Join Now?

What attracts you most about becoming a Founding Member? (Select up to 3)

 *
1 point
Required

What do you feel you could contribute to the House of Influence community? 

 *
When you picture yourself as a Founding Member, what’s the first opportunity or connection you want to create in your first months with us? *
Thank you!

Thank you for sharing your vision with us.
You’re just one step away from joining the Founding Members of the House of Influence — a circle of women shaping business, leadership, and connection on a global scale.

Our team will review your responses. In order to book a call please contact: teresa@ispeakuplightup.com

We look forward to building with you — the time is now.

Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Kolibri Productions Group Ltd..

Does this form look suspicious? Report

Google Forms