Membership Application Please complete this form to begin the process of being placed on an Opportunity Knocks team. Thank you for your thoughtful answers. We look forward to working with you! Name* First Last Phone*Name of your company or organizationBusiness mailing address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Website Please tell us about your career/experience*Briefly describe your company or organization*What is your job title?*What are your daily duties and responsibilities?*How many full time employees are in your company?Where is your place of business?* Home office or remote Leased space Store front Own building(s) Which of the following best describes your business?* Boot-strapped startup Funded startup Second stage business (passed startup phase and looking to grow) Mature business (more or less even revenue) International business What is your approximate annual revenue? Less than $250K $250K to $500K $500K to $1 million Between $1-5 million Over $5 million How many years has your business been in operation?* Less than one year One – two years Two – five years More than five years Billing Information*Businesses over $750K Revenue = $1,500Businesses under $750k Revenue = $750Accelerators and Nonprofit Teams = $550Additional Members from any size business = $550What are your goals in the next 12 months for you and your company?*What would you like to be held accountable for?*What do you hope to gain from being an OK member?*What skills and expertise can you contribute to your team members?*How did you find out about Opportunity Knocks?*Current OK memberCurrent OK facilitatorAn OK board memberSocial mediaThrough another organizationI was a member in the pastOtherAre you a returning OK member?* Yes No OK’s purpose is to provide you with a board of advisors that meets monthly to help you in your career and business growth. To help make your OK experience a success, we ask that you agree to the following statements. Check the boxes to indicate your agreement.* Confidentiality: I will honor confidentiality and will not discuss any information from team meetings with anyone outside of my team. Commitment: I commit to missing no more than three meetings per year. In the event of a necessary absence, I will notify my facilitator in advance of the meeting. Accountability: I will be accountable to my team members by either acting on all action items recommended to me or reporting back on which ones were achieved. Collaboration: I will actively participate by presenting strategic issues and by providing feedback and suggestions to my teammates. Participation in OK is required for a minimum of one year. No refunds will be made within the year and members must send an email if they decide they cannot renew after a year.Initial here to indicate you agree to the guidelines for participation in Opportunity Knocks.*Thank you for your application! You will soon hear from someone who will work with you to place you on a team. At any point in the team placement process we’re here to answer your questions! Feel free to email info@opp-knocks.orgPlease verify: