Apply for membership

Your name *
First Last
Your email address *
Your phone *
### - ### - ####
(Optional) Your business name
Your preferred business category (or select 'Other category" below.)
This is a list of the remaining available categories.
(Optional) Other category
If your business category is not listed above, type it here. For example: "Phrenologist"
(Optional) - a portrait picture of you

Add File

If you have one handy, it will help us complete your profile on the Leads Northwest website if your membership application is accepted.
Membership acceptance *
I understand that completion of this form, or completion of the PayPal subscription after this page, does not guarantee membership acceptance.
Minimum Attendance *
I understand that membership requires attendance of at least 90% of our weekly meetings, either in-person or remotely by way of Zoom.
Leads *
I understand that each member is required to make their best efforts to bring a minimum number of leads to other members in the chapter in a given month.*
*This minimum number of required leads is currently one per month.
Press the big orange Send button now to move to Step 2 of the application.