New Member Questionnaire
*
- Required Field
First Name *
Last Name *
Email *
Company Name
Phone
Assigned Ambassador's Name
Date of Visit
Primary Contact: Please enter in Last Name, First Name
Title
Email (Primary Contact)
Secondary Contact
Secondary Contact Title
Email (Secondary Contact)
Name of person who handles your marketing
Marketing Rep Email
Number of Employees
Full-time
Part-time
Seasonal Employees (include date range of seasonal employment)
Year business opened
Why did you join the HCC?
What resources or programs are you interested in?
Is there something specific that the HCC can do for your business?
Who is your target customer or client?
Is there a specific HCC Member or Member Business that you would like the HCC to introduce to you? (We will do our best to facilitate an introduction.)
Please mark any that apply to your business
-- No Selection --
Veteran Owned Business
Woman Owned Business
Minority Owned Business
Family Owned Business
501(c)(3) Business
Home Based Business
Green (Environmental) Business
Choose 1
I received my HCC plaque in the mail *
Yes
No
I am receiving HCC Newsletter and Event emails *
Yes
No
I completed my HCC Online Member Directory Profile Page *
Yes
No
I would like to introduce my company to the HCC Members by being an Event Sponsor *
Yes
No
I would like to introduce my company to the HCC Members by using a low-cost advertising tool (as little as $50) *
Yes
No
I follow the HCC using
Select all that apply
Facebook
Twitter
LinkedIn
Visiting the Website
Via HCC Eblasts
I am interested in joining the HDA (Henderson Development Association)
-- No Selection --
Yes, please invoice me.
Maybe.
Not at this time but please contact me in 6 months.
No.
Choose 1
I am interested in contributing to IMPAC (Issues Mobilization Political Action Committee)
-- No Selection --
Yes, please contact me.
Maybe.
Not at this time but please contact me in 6 months.
No.
Choose 1
I am interested in these topics and/or presenters
Questions or comments
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