Please fill out the form below:

Chamber Leads Group 4 Application Form
Name:
Company:
Title:
City:
State:
Zip:
Work Phone:
Cell Phone:
E-Mail:
Current Wichita Metro Chamber of Commerce member? Yes No
Detailed description of the products and/or services your company offers:
Why are you interested in becoming a member? (Specifically Chamber Leads Group #4)
What type(s) of leads will you be able to provide to the group?
What type(s) of leads would you be looking for from the group?
The Chamber Leads Group #4 require regular attendance; will you be able to commit to attending at least 4 meetings per quarter?




Disclaimer: Approval to join the group will be given by the Chair after the group members have had an opportunity to review any and all requests for membership. If there is a conflict with a member within the group, such applicants will be notified and placed on a waiting list.