"*" indicates required fields Your Name* Full Name About Prospective MemberProspective Member Name* Full Name Business Name* Category* How do you know Prospective Member?* How long have you known Prospective Member?* Have you worked professionally with Prospective Member?* Yes No Are you confident in referring her products/services to others?* Yes No Unsure Are you aware of any potential category conflicts with any currently active members?* Yes No If yes, please list*Does prospective member have additional business interests/involvement beyond the original application?* Will you attest to the best of your knowledge to the prospective member’s ethical standards?* Signature*Date* Month Day Year Δ