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* 1. First and Last Name

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* 2. Email

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* 3. Phone Number

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* 4. Referred By

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* 5. Company Name

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* 6. Job Title/ Role

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* 7. Years in Business

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* 8. Number of Employees

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* 9. Past 3 Years of Revenue

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* 10. Do you have any experience with EOS?

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* 11. If yes, how many years of experience do you have with EOS? 

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* 12. If yes, who is your EOS Implementer?

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* 13. Social Media Profiles

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* 14. Why are you interested in becoming a member of the BAR? 

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* 15. What specific expertise or experience do you bring to the roundtable discussions? Please provide a brief overview. 

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* 16. What challenges or opportunities are you currently facing?

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* 17. What areas of your business are strongest?

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* 18. How do you think participating in the roundtable will help address #16 and amplify #17?

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* 19. Describe a recent accomplishment or project you have been involved in that highlights your skills and expertise: 

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* 20. Are there any particular topics or areas of interest you would like to explore, learn more about or discuss during our sessions?

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* 21. What qualities or attributes do you believe make for effective and collaborative roundtable discussions? 

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* 22. Have you participated in any other roundtable or networking events in the past? If yes, please briefly describe your experience.

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* 23. Will you commit the time and frequency required to create value from participating in the roundtable sessions? (Monthly online sessions ~ 3 hours each as well as 3 in person meetings) 

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* 24. How did you learn about our roundtable and what motivated you to apply? 

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* 25. What are you looking to gain by participating in the BAR? 

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* 26. What must be true a year from now – in your business, as a leader and in your life – to consider your participation a success?

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* 27. Is there anything else you would like us to know about you or any additional comments you would like to share? 

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