Name

Business

Type of Service Provided

Years in this Field

Years at this Particular Business

Address

Phone

Email Address

Sponsor (Current Member)

Reference (other than sponsor)

Reference Phone

Additional References

I understand that, as a Member of Ionia Innovators (the “Group”), I will have the opportunity to grow my business bypassing referrals within the Group. I have read the Organizational Rules for the Group, and I agree to follow those rules upon my acceptance into the Group. Particularly, I am aware of the attendance policy and fees. I also understand and agree that I may be removed from the Group for any of the reasons listed in the Operational Rules.

I believe I am a good candidate to become of Member of Ionia Innovators because:

Date

Name

Email Address

Message