Coeur Group Application
Coeur Group strives to be an inclusive and will only accept a limited number of new organizations for each partnership year.
First Name / Last Name
Email Address:
Physical Address:
Birthdate:
MM
/
DD
/
YYYY
Industry:
Company/Position:
Who referred you to The Coeur Group:
What is your favorite kind of beer?
Clear selection
Are you involved in other community volunteer programs? (Please Describe):
Have you been trained in martial arts?
Clear selection
Where do you plan to be in 5 years (location):
Do you like ducks:
Clear selection
Do you like Nickelback? (There is only one right answer, choose carefully...)
Clear selection
I have answered the above questions truthfully, honestly and correctly. Please submit your completed application, and if you are accepted as a member, you will be invoiced for our annual membership dues of $120.
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