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| Name |
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| Title
Company
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| Address
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| City
State
Zip
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| Bus. Phone
Fax
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| Mobile
Email
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In an effort to bring in new members that will be synergistic with the rest of the group and most likely to mutually benefit from the group’s success, APEX aims to solicit membership from individuals who are already successful in their respective fields. As such, our goal is to invite members who have been in their particular industry for at least 5 years and who have annual revenues in excess of $200,000. Does your business meet these guidelines? In no, please explain.
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| Description of your business |
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| Length of time that you have been with this company
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| Length of time with prior company if above is a start-up |
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| Organizations/Associations in which you are a member
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| Also indicate leadership positions held, if any
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| Are there any existing members of APEX to whom you may not be able to refer business, or with whom there may be a conflict of interest with your business?
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| How do you believe you can be of assistance to members of APEX?
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| What benefits do you think you will derive from joining APEX?
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| Describe your company’s plans for business development:
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REFERENCES
Please give the names of two clients we may contact. |
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| 1. Name
Company
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| Phone
Type of Referral
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| 2. Name
Company
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| Phone
Type of Referral
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| Please give the names of two colleagues to whom you have referred business. |
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| 1. Name
Company
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| Phone
Type of Referral
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| 2. Name
Company
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| Phone
Type of Referral
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| The name of your Sponsoring Member
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| Please return the completed application to Bart Zandbergen, at your earliest convenience. Mail to: 26041 Acero, Mission Viejo, CA 92691. |
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Application and Summary of Guidelines |
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- APEX members are expected to attend all semi-monthly meetings (one breakfast, and one dinner meeting each month). In order to remain a member you must not have more than 4 unexcused absences in a row, or miss a total of more than 25% of our regularly scheduled meetings. Due to the small group size, attendance is extremely important.
- APEX members are encouraged, but not required, to allow other APEX members to bid on services to be performed for their own company or for client. APEX members are further encouraged, but not required, to use and refer the services of other APEX members when possible.
- APEX members and their businesses are expected to deal with other APEX members and referrals from APEX members in an ethical manner.
- Monthly dues assessments for membership in APEX must be paid via recurring, credit card authorization. If, for whatever reason, a payment is missed, there will be a $25.00 late charge. If the monthly dues assessments continue to remain unpaid, the member may be terminated from membership at the sole discretion of APEX.
- APEX shall have the right to set monthly dues assessments. The monthly dues assessments may be changed at any time at APEX’s sole discretion, provided, however, that APEX shall provide all current APEX members written notice of any change in monthly dues assessments at least thirty (30) days prior to the effective date of any such change.
- An APEX member may resign from membership in APEX at any time after 30 days’ written notice to APEX of the member’s intent to resign. Membership processing fees and prior months' dues assessments are not refundable.
- While APEX will conduct a cursory reference check as part or our membership application process, APEX does not conduct a full background or credential check any individual admitted in APEX, nor the firm by whom the member is employed. APEX makes NO WARRANTY EITHER EXPRESSED OR IMPLIED as to the credentials of any APEX member, the firm by whom the APEX member is employed, or the goods and services provided by any APEX member, and shall have no liability whatsoever for any goods and services so provided.
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Statement of Commitment |
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If accepted as a member of APEX, I will actively strive to know my fellow members and their businesses. I will attend meetings regularly and will actively participate in seeking ways to promote my fellow members’ businesses. I will attempt to provide at least one meaningful prospect reference to another member at each meeting.
 I have read the summary of guidelines for members of APEX and agree to be bound by them. I further understand that my violation of the guidelines constitutes grounds for my dismissal as a member of APEX at the sole discretion of APEX. |
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| Signature
Date
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| Application Fee:Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â $99.00 |
| First Month’s Dues:       $199.00 |
| Received                       $
.00 |
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| INSTRUCTIONS: |
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| This form is to be submitted by each new member (along with the above referenced fees and the completed automatic credit card billing form) to APEX. The initial fee described above may be remitted by check or may be billed to the new member’s credit card if he or she so desires. |
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| Automatic Credit Card Billing |
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Please charge my MasterCard/Visa/AMEX Card for the following:
       One-Time Membership Processing Fee: $99.00 (processed with first month's dues)
       Monthly, Recurring Membership Dues: $199.00 (processed on the first of each month)
Indicate Card Type: |
| Master Card
Visa
American Express
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| Account Number:
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| Expiration Date:
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| CID (if applicable):
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| Name on Card:
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| Billing Address:
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| I can terminate this automatic credit card billing by notifying APEX by either mail or fax by the 25th of the month preceding the following month’s processing date. |
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| Signed:
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