LevelUp! Roundtable
Thank you for your interest in the Roundtable! We're excited to see how this community comes together and supports one another in the LevelUp! process.

This is the application for membership in the next 6 month cohort (date TBD) This form provides additional information about the program including the investment and commitments you're making in your success. The standing meeting time is currently planned for the first Tuesday of every month at 1pm Eastern time.

We're asking for a valid email so we know who you are and how to contact you.
Email *
Your financial investment in the future of your business
If you're accepted, we'll invoice for the investment of $4,450.00 (US, due on receipt) which includes:

- Program setup (including an invitation to the online community)

- Everything DiSC Workplace Profile survey and personalized report

- Initial business coaching session

- Ad hoc Email & SMS coaching support

It also secures your position in the cohort for 6 months.

If you apply before June 1st, you'll get a $200 early-bird discount!
Your name (first, and last, please) *
Your phone number
We're asking for this so we can contact you if we send an email and don't hear anything back from you.
Business Name (or, leave this blank if you don't have a business name)
Company Size *
We're asking for this so we can get a sense of the group dynamic and to determine whether the Roundtable for Entrepreneurs is the right Roundtable for you.
Commitment *
Please review the list below. These items set the expectations for the kind of peer group experience we seek to create together. If you're unable to agree to all the items, it might be that this type of group isn't a good fit for you yet. If you have a question or concern, please contact us so we can explain how it works.
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 Wise Insights, LLC. Report Abuse