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Enjoy Peer Advisory Board of Like-Minded Christian Business Leaders

I would like to pursue C12 membership. Please contact me to discuss "next steps." The information below is provided to be helpful in launching this process.

First Name:

Last Name:

Title:

Direct Phone No:

Email:

Company:

Address:

City:

State / Province:

Zip:

Employees:

Annual Sales:

Which of C12 Membership 7 Advantages are most important to you at this time (Check top 3)

Working "On" My Business

Christian Board of Directors

In-Depth Analysis of My Business

Accountability to the Group

Business Coaching

My Business as Ministry

Devotion and Prayer

Accountability to the Group

Please contact me regarding:

C12 Membership

Key Player Membership

Alpha Group Membership

Starting a C12 Group in my area

C12 Business Opportunities

Other (please describe below)

How did you become aware of C12?

Businessasmissionnetwork.com

C12 Direct Mailer

ChristianPost.com

Fast Company Magazine

Fortune Magazine

Google Ad

Google Search

Inc Magazine

Iron Sharpens Iron

Referral from Colleague

Success Magazine

Wall Street Journal

Web/Print Article

Web search

WORLD Magazine (print or web)

Facebook

LinkedIn

GodTube

YouTube

Other:

Describe here

Other Comments/Questions/Requests:

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