Club Conduit Membership Application

Part One

Full Name *

Company / Organization *

Current Title or Role *

Industry *

City / State *

Phone *

Email *

LinkedIn Profile *

Website or Portfolio (if applicable)

Part Two

1. Please describe your current professional role and the organization or venture you lead or contribute to. *

2. What level of decision-making authority do you currently hold? *

Founder / Owner

Executive Leadership (C-Suite / Partner)

Senior Leadership

Investor / Board Member

Independent Professional / Consultant

Other

3. What stage best describes your company or primary venture? *

Startup / Early Stage

Growth Stage

Established Business

Multi-company portfolio

Investor / Capital allocator

4. What are the primary industries you currently operate in? *

Part Three

5. Which of the following best describes your economic role? *

Builder (operating a company)

Capital allocator / investor

Advisor / strategist

Combination of the above

6. Over the next 3–5 years, what type of capital or growth are you actively pursuing? *

Scaling business revenue

Raising capital

Investing in companies

Real estate expansion

Strategic partnerships

Industry influence

7. What types of opportunities are you most interested in accessing through Club Conduit? *

Investment opportunities

Strategic partnerships

Deal flow

Access to capital

Thought leadership

Collaborative ventures

Part Four

8. What expertise, access, or perspective would you bring to the Club Conduit community? *

9. What type of members would you most enjoy collaborating with? *

10. Describe one meaningful professional collaboration that significantly accelerated your growth. What made it successful? *

11. Club Conduit is built on the principle of circulating opportunities among members. *

12. Can you give an example of how you’ve opened doors, shared opportunities, or advocated for others in your network? *

Part Five

12. What impact do you want your work to have over the next decade? *

13. What leadership values guide your work and decision-making? *

14. What motivates you to pursue success beyond financial gain? *

Part Six

15. Why are you interested in joining Club Conduit? *

16. What does “circulating capital and opportunity among women” mean to you? *

17. What would make membership in this community meaningful and valuable for you? *

Part Seven

19. What does ethical leadership mean to you in practice? *

18. Club Conduit prioritizes collaboration over competition. How do you typically approach professional relationships within high-performing environments? *

Part Eight

20. How did you learn about Club Conduit? *

Member referral

Event

Social media

Personal invitation

Other

Part Nine

21. What is one goal you are actively working toward that the right network could accelerate? *

22. Is there anything else you would like the selection committee to know about you? *