Membership Application

JOIN THE LAKENET TEAM

Please complete the following online LakeNet Membership Application form. The Membership Committee will review your application at the next regular meeting and our Membership Committee chairperson will be in touch with you as quickly as possible to confirm your application status.

Membership Application

Name

Email Address

Phone

Company Name

Company Address

Company Website

Job Title

Years with company

Years in profession

Describe the products and/or services you will be representing

What is a good referral for you?

What do you feel you can contribute to LakeNet

Can you attend weekly meetings in accordance with the LakeNet bylaws? Can you attend weekly meetings in accordance with the LakeNet bylaws? Yes No

Please list one professional reference, including name, company, and contact information

Who is your LakeNet Sponsor?

10 + 15 =

Note: The Federal Equal Opportunity Act prohibits employers, clubs, groups or said organizations which require membership from discriminating against applications for employment, enrollment or membership in that said organization on the grounds of race, color, creed, religion, national origin, sex, marital status and age (providing that the application has the capacity or is legally of the age to enter into a binding agreement).