Application to Start a W.I.N.G.S. Chapter

Name:
Business Name:
Brief Description of your business:
Length of time you've been in business:
Address:
Business Phone:
Home or cell Phone:
E-Mail:
Nearest WINGS chapter: 
Why would you like to head up a WINGS Chapter?
What skills do you bring to WINGS?
Who will be your assistant?
How long have you known your assistant?
and how do you know your assistant?
What community will you be hosting your WINGS chapter in?
Name of location?
Address:
Phone:
What month do you plan on launching your WINGS chapter?
What day do you plan on holding your WINGS chapters?
What time do you plan on holding your WINGS chapter?
Do you belong to any other Business Women’s groups? Which?

How can we best contact you?

Time: AM PM   
  By Phone or by E-Mail
Date: