Jill's Accountability Circle Application

Where Decision-Makers Connect, Confide, and Collaborate

Join other business leaders in a facilitated, confidential, peer-peer environment.

To be considered, you must:
• Lead as an executive
• Value meaningful connections with peers
• Respect confidentiality and non solicitation rules
• Commit to consistent attendance

Complete this form to join our invitation list. Jill will personally reach out to qualified applicants.

*At this time, we are unable to accept applications from anyone who owns or works for or in a family-owned business.
1.First and Last name
2.Company Name
3.Industry or NAISC Code
4.Cell phone number
5.Email
6.Title
7.Number of employees
8.Revenue
9.Groups I am interested in - you may choose more than one (and then we'll discuss best fit). $3,750 per year unless noted:
10.Anything else Jill should know that doesn't fit in the box below? Send her an email: jill@meetatjills.com