Membership Application:

Before continuing on this application please ensure you are a Core applicant, if you are a B2B applicant please go to www.b2bnexco.com/join.

 

Full Name [required]

Job Title

Email Address [required]

Phone Number (555-555-5555) [required]

Profession [required]

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Select Profession
Company [required]

(How your company name is printed here is how it will appear on your neXco National Name Badge)

Best Mailing Address

(Your neXco National name badge will be mailed here)

Upload Company Logo

Website URL

Please include a short bio [required - not to exceed 200 words]
How did you hear about neXco National?


What city do you live in?

What city do you perform the majority of your business in?
Chapter you wish to join:
Ashburn CoreGainesville CoreLeesburg CoreMosaic CoreReston CoreTysons Core
Status:
Attended my first chapter meetingAttended my second chapter meetingBusiness & Beverages EventCocktails & Commerce EventLooking forward to attending my first meeting
How are you currently securing business?:
Existing ClientsCompany accountsReferralsLeads from marketing
I am interested in a leadership position in the chapter?:
YesNo
 

Top 3 professions that refer to you:

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Select Profession
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Top 3 professions that you refer to:

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Who is paying for the membership?:
Company MembershipPersonal Membership

Invoices should be sent to:

I have read and agree to the 'Membership Agreement' below. [required]
I have read and agree to the 'NeXco National Code of Ethics' below. [required]
I confirm my name and company name are how I want them printed on my neXco National name badge. [required]