All interest forms and company profile information be kept entirely confidential. The purpose of this survey is to connect NECA members with a facilitator that will provide the greatest potential fit. Completion of this form does not obligate joining a Peer Group. Please direct any specific questions to Ian Andrews, Field Representative, ian.andrews@necanet.org. 

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* 1. Please fill out the information below:

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* 2. What is your most recent annual sales volume?

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* 3. Please list your home office location(s), branch locations (if applicable), and typical geographical area.

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* 4. What price range are you comfortable investing annually to be a part of a peer group? (check all that apply)

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* 5. How soon do you wish to join a Peer Group?

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* 6. A typical peer group meets at least twice annually at locations to be determined across the country. Are you willing to commit to this level of participation?

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* 7. What are your goals and expectations of participating in a Peer Group?

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* 8. Additional questions concern or comments.

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