Leaders aspiring to become members of C12 are invited to test the value for themselves as a guest at an upcoming Forum.
To request an invitation, complete the form or contact:
Email: [email protected]
Phone: 973-615-4120
Country *
Name *
E-Mail *
Cell/Mobile Phone *
Zip Code *
Corporate Title *Owner/PartnerPresident/CEOC-Level (CMO/CFO/COO etc.)Senior Exe./Vice PresidentOther
Local Church/Worship Attending *
Company Name *
Number of Employees *Less Than 1010-5051-100101-500500+
Business Majority Owner? *YesNo
Years in Position *Less than 1010-2020+
Industry *
Company Address Information *
Company Phone *
Website *
Annual Revenue *Less than $1MM$1MM-$2MM$2MM-$5MM$5MM-$10MM$10MM-$50MM$50MM+
Business Description *
I agree that I do/will fulfill the requirements of Membership Qualifications and Membership Expectations detailed above and understand that a breach of any of the criteria could result in a non-refundable cancellation of my membership. *
I understand that membership is automatically renewed unless at least one month’s notice is provided. I also understand that all dues must be paid monthly and kept current by arranging payment prior to each month’s Forum or FOCUS60. *
Before terminating my membership, I pledge to express my intention and reasoning to my Business Forum peers. *
In full agreement with the above, I desire to become a member of C12. *
