Please complete your Chapter Head application below.

Name

First Name

Last Name

Title

Company (Broker/Dealer or RIA Name)

Licenses and Designations Held

(i.e. FINRA Series 7, Insurance, CFP®, etc.)

Email Address

Phone

(###)

###

####

Website

http://

Birthday

YYYY

In what city and/or region would you like to establish a group?

Briefly describe your service offerings. What is the core of your business mix? Do you use Financial Planning?

What are your current strategies in place to help you grow your practice? Are you, or have you been, involved in any other networking groups?

Briefly describe your goals in establishing a Chapter of The W Source™.

How many hours per week do you have available to devote to building your Chapter?

How did you hear about The W Source™?

Additional Information:

I acknowledge that I am in good standing for my profession, and if I claim a professional credential (e.g. CFP, CPA, Atty, etc.), that I am in compliance with the standards of that industry.

I agree.

I acknowledge that all members are required to sponsor a Monthly Meeting breakfast or lunch for the group once every 15-20 months (depending on the group size) and are given the opportunity at that meeting to showcase their business during the "Member Showcase."

I agree.

I acknowledge that refunds are at the discretion of The W Source™.

I agree.

I have read and accept the Terms, Conditions, and Responsibilities of Membership.

www.thewsource.com/terms-conditions

I agree.

I have read and agree to the Privacy Notice.

www.thewsource.com/privacy-policy

I agree.