Facebook Application - Creatives' Roundtable

First Name*
Last Name*
Email*
Cell Phone Number*
Mailing Address*
Title
Business Name*
Business Website
Facebook Profile*
Copy and paste your Facebook profile so we can invite you the private Facebook group.
Why do you want to join the CR?*
What are your greatest Strengths/Weaknesses in business?*
If you were not a creative, what would you be?*
Favorite social media platform?*
Creative mentor/inspiration/hero?*
Number of years in business*
Business Birthday*
Date Format: MM slash DD slash YYYY
Who referred you?
If someone referred you to the CR, please list them here:
Your Birthday*
Date Format: MM slash DD slash YYYY
This 12-month payment is not refundable.*
- I understand and agree
EMAIL LIST*
I agree to be placed on the Creatives Roundtable email list, which might come from EventBrite or Ruzow Graphics. I understand I can unsubscribe at any time.
- I understand and agree
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