WIN Member Application

Please complete this form to be considered for membership. Annual dues to join Women In Networking are $150 (or $13/month prorated for partial year). Dues must be submitted upon acceptance of the application. Please make checks payable to Women In Networking.

Submit application or questions to the Membership Committee Contacts: Jill Loof & Ellen Corey:   Ellen: ellen@coachingbycorey.com   or Jill: jlooff@yahoo.com 847-668-7289

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Your First Name *
Your Last Name *
Business Name *
Business Physical/ Mailing Address
Business Telephone *
Mobil Telephone if different
Business Email *
Business Website
Home Address
Business Category
How did you hear about Women In Networking?
WIN is a non-compete networking organization. To avoid conflict, provide the primary focus of your business. Write a brief description of what you do, and how you intend to network in WIN *
List three business specialties or add-ons in detail that you would like to share with the group.  *
Which committee(s) would you like to serve on (descriptions can be found on https://winlz.com/our-board/) *
Required
Please select one: *
Anything else?
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