CEO Collaborative Application

Please complete the application.

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Name

Title

Company

Office Phone

Mobile Phone

Assistant who should be included on travel/meeting details:

Assistant Name

Assistant Email

If appointed, I commit to participating in the CEO Collaborative in 2025.

I understand my participation is important and will do my best to attend in-person meetings of my group.

I understand the annual fee covers my meeting and related experiences; it does not cover hotel or travel costs and is non-transferable to another person or event.

I would be interested in hosting or planning a future event for my group.