Bridgewater Multi-Chamber Azusa Leads Group – Application Form

Azusa Leads Group Application Form

Business Contact Information

First Name

Last Name

Business Name

Title / Position

Business Category (Main)

Business Category (Alternate)

Business Website

Business Phone

Instagram Tag

Any other social media

Business Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Tell us about your business

Briefly tell us about your business

What do you hope to gain by joining this group?

What types of businesses typically generate referrals for you?

Who is a good referral partner to you?

What types of businesses do you provide referrals for?

Do you belong to other lead generation groups or networking organizations?

Yes

Which ones?

Can you commit to attending a Leads Group twice a month?

Yes

Can you commit to at least two 30 minute 1-on-1 meetings per month?

Yes

How did you hear about Bridgewater Leads Group?