WEST BOCA LEADERS MISSION STATEMENT & MEMBERSHIP
APPLICATION
West Boca Leaders is a referral network of business and professional people.
Its purpose is to refer and do business with other members.
Membership is made up of individuals of high integrity representing
different fields of endeavor, limited to only one member from each field. Members are sponsored or solicited by other members, specifically
selecting people who they personally have done or plan to do business with.
Membership is a privilege with integrity and commitment expected
of all. The group meets every Wednesday promptly at 7:30 AM to 8:30 AM at
Wings Plus, 10125 Glades Road in the Mission Bay Plaza in West Boca. Cost
for bagels and coffee is $240. annually. Members are expected to be prompt
and attend regularly for the hour, considering the meetings as a business
appointment and not be a member of any other local networking group in the
area. No other networking group memberships are allowed. Please bring your
check with this application to your next meeting.
Tel: 561.852.0000 – Fax: 561.451.0000 – e:mail: pr@publicrelations.nu - website:
www.publicrelations.nu
NAME______________________________________ TITLE____________________BIRTHDATE_________
BUSINESS
NAME_____________________________
CATEGORY________________________________
BUSINESS
ADDRESS___________________________CITY, STATE, ZIP_____________________________
BUSINESS
PHONE_____________________BUSINESS FAX__________________E-MAIL______________
CELLULAR
PHONE_____________________BEEPER________________HOME PHONE________________
HOME
ADDRESS_______________________________CITY,STATE,ZIP______________________________
PRINCIPAL OWNERS
NAME_______________________HOW LONG IN BUSINESS___________________
# OF EMPLOYEES F/T & P/T
__________ TYPE OF
BUSINESS_____________________________________
WHO IS YOUR
CUSTOMER?_________________________________________________________________
BUSINESS REFERENCES (2) BUSINESS
NAME_________________________________________________
CONTACT NAME
_________________________ADDRESS________________________________________
CITY,STATE,ZIP___________________________PHONE_______________________________________
BUSINESS NAME_____________________________
CONTACT NAME______________________________
ADDRESS_____________________________CITY,STATE,ZIP_______________________PHONE_________
ARE YOU CURRENTLY IN ANY OTHER
NETWORKING OR BUSINESS REFERRAL GROUP?___________
IF SO, WHEN AND WHERE DO THEY
MEET?___________________________________________________
WHAT CHARITABLE, CIVIC OR
PHILANTHROPIC ORGANIZATIONS DO YOU BELONG TO?
_________________________________________________________________________________________
AS IN THE ABOVE MISSION STATEMENT OF THE WEST BOCA LEADERS, WE EXPECT OUR MEMBERS TO BE PRESENT EVERY WEEK, ON TIME AND TO ACTIVELY PARTICIPATE IN THE GROUP. ARE YOU WILLING AND ABLE TO MAKE THIS COMMITMENT?__________SIGNATURE___________________________________