Step 1: Personal Information

First Name

Last Name

Company Name

Current Position

Email Address

Business Address

City

State

Zip Code

LRN Position Applying For

Step 2: Questionnaire

Please describe your professional experience.

How does referral-based business fit into your marketing plan?

What businesses or industries do you currently refer business to?

What areas do you currently provide service in?

How would you describe your ideal customer?

Does your job require a license to perform in Douglas County? Yes No

Are you bonded or insured for your trade/position? Yes No Not Applicable

Step 3: Business References

Business Reference 1

First Name

Last Name

Company Name

Title

Email Address

Phone Number Please enter phone in following formats:

without extension: 123-456-7890
with extension: 123-456-7890 1234

Business Reference 2

First Name

Last Name

Company Name

Title

Email Address

Phone Number Please enter phone in following formats:

without extension: 123-456-7890
with extension: 123-456-7890 1234

Business Reference 3

First Name

Last Name

Company Name

Title

Email Address

Phone Number Please enter phone in following formats:

without extension: 123-456-7890
with extension: 123-456-7890 1234

Step 4: Personal References

Personal Reference 1

First Name

Last Name

Company Name

Title

Email Address

Phone Number Please enter phone in following formats:

without extension: 123-456-7890
with extension: 123-456-7890 1234

Personal Reference 2

First Name

Last Name

Company Name

Title

Email Address

Phone Number Please enter phone in following formats:

without extension: 123-456-7890
with extension: 123-456-7890 1234

Personal Reference 3

First Name

Last Name

Company Name

Title

Email Address

Phone Number Please enter phone in following formats:

without extension: 123-456-7890
with extension: 123-456-7890 1234

Step 5: Terms & Submit Application

Your Application Means:

Lawrence Referral Network can contact my references
The information I filled out is correct to the best of my knowledge

Dues

Payment must be received upon acceptance into the group

40% of dues are used for the administration & marketing of LRN
60% of dues are given to a local charity,non-profit organization or other voted upon by the group

Guests may visit 3 meetings before deciding upon membership with the group

I understand & agree to the above information

Create Membership Application

Your Application Means:

©2024 Lawrence Referral Network | All Rights Reserved
Website by: RAHA Digital Solutions

Success!

Create Membership Application

Your Application Means:

©2024 Lawrence Referral Network | All Rights ReservedWebsite by: RAHA Digital Solutions

©2024 Lawrence Referral Network | All Rights Reserved
Website by: RAHA Digital Solutions