Tech Vendor Application - CRC/Innovation Council
Thank you for your interest in joining! Please complete and submit this form for review.
Email address *
Your Name *
Your Job Title *
Your Firm Name *
Your phone number *
Please check which memberships/subscriptions you are interested in *
Please provide the email address where your invoice should be sent *
Please provide contact information for those who will participate on behalf of your firm.
Include for each person:
Job title
Email address
Phone number

Please note:
Membership is limited to senior executives and non-sales leaders who are in product, engineering, IT, operations, strategy, legal, or compliance. We recognize some sales leaders have an extensive operations background. Exceptions may be made in this case, but a review is required.

If you are a returning member and your participants are not changing, you may simply type "SAME".
For the INNOVATION COUNCIL (type n/a if not joining this group) *
For the CRC (type n/a if not joining this group) *
Please select the categories in which your firm provide products/services *
Please describe the areas in which your firm is innovating in the coming 1-2 years *
Do you currently offer products/services that employ data science? (e.g. Are you using tools such as Random Forest regression to model portfolio or treatment actions to identify the most predictive attributes?) *
If you answered "yes" or "other" above, please briefly describe
Do you currently offer machine learning-based products/services? (e.g. Does your system automatically improve on prediction of best treatment strategy based on data science, without being explicitly programmed?) *
If you answered "yes" or "other" above, please briefly describe
Please confirm that you understand the following:
In addition to the applicable membership dues, there is a $225 fee per person to attend CRC and Innovation Council meetings (a separate fee of $225 applies to each meeting -- so if an individual is attending both, the total fee would be $450).

The CRC and Innovation Council are non-sales zones, for individuals at a leadership and/or decision-making level. The goals are relationship building, education, and collaboration.

Professionals whose job responsibilities are solely sales/business development-related are only permitted to participate to the extent they personally have an extensive operations background and can contribute to the discussion on that level. We recognize there is educational value for sales executives to participate, but please understand that the success of these meetings depends on attendance by the right people, at the right level, every time. If members start to see an abundance of junior and/or salespeople, they will stop attending. The whole concept will fall apart.

Members gain the most value by the give and take of everyone in attendance. If some only come to take and just sit quietly, those who give will grow resentful and stop doing so. The whole concept will fall apart. Members are not expected to reveal their "secret sauce." However, we do expect sincere participation by all attendees.
On behalf of my firm, I confirm the above *
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of insideARM. Report Abuse