Membership Application

Have an account? Click here to log in...

Click here for more about which membership fits you.

Membership:

Executive Membership ($500) - Enhanced benefits for increased visibility and access

Professional Membership ($150)

General Membership ($50)

Professional Membership for employees of platinum corporate investors ($100)

Young Professional 6 month Membership ($35) - One time use only. For individuals 18 - 33 years of age

Region Referred By: Create a Login Name: Login Password: Retype Password: Prefix: First Name: Middle/Initial: Last Name: Suffix: Title: Company: Address Type: Address: City: State: Country: Zip Code: - Phone: Type: Phone 2: Type: Email: Email 2:

Demographics

These questions are optional. Providing this information helps us meet your needs, and better understand our membership.

Industry Occupation: Ethnicity (select one or more):

African American

Arab American

Asian American

Caucasian

Hispanic

Native American

Pacific Islander

Other

Prefer not to say

Gender: Birth Date: / / Year of Birth:

Social Media

LinkedIn Facebook Twitter

Executive Members ONLY

Executive Members receive additional visibility and recognization. Please complete the questions below.

Web Site: Business Mission Educational Background Memberships, Board Positions, Etc. Her Personal Side Most People Don't Know Something You Should Know Words of Wisdom

Communications

Please indicate below what programs and initaitves you would like to receive communications about.

Region:

Southeast Michigan

West Michigan

Virtual