Wildflower application

Hey Potential Wildflower! Thank you for your interest in joining Wildflower Connections. As a potential member, we ask you to complete the form below as a start to our application process. Once submitted, Cindy and Jenn will review and reach out to you to schedule a formal coffee and connection chat.

Name

First Name

Last Name

Birth Date

YYYY

Business Name & Industry

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What is your favorite song?

What are 3 words that describe you?

What motivates you?

How do you think Wildflower Connections will benefit you?

Why is entrepreneurship right for you?

What are 3 of your strengths and 3 items you would like to work on?

Were do you see yourself in 5 years?

What is the last book you have read or listened to?

I understand that completing this application is not an automatic approval into Wildflower Connections.

Yes, I understand.

Wildflower Connections Cancellation Policy

I understand that I can cancel my membership at any time by emailing membership@wildflowerconnections.com. There are no refunds given for cancelled memberships.

Yes, I understand.

I give Wildflower Connections permission to publish any pictures or videos taken of med durting the meeting.

Yes, I understand.