SoCal IT Roundtable Online Application 1 Applicant Information2 Business Details Name* First Last Email* Receive Email Updates? Receive email updates? Phone*Company Name*Company Website 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 What is your technology or business niche?*Please give a high-level description of your business.*What are your core offerings?*What is your target client profile?*How long have you been personally selling in the SoCal market?*How do you define the term selling?*What are your current business networking activities?*What value do you seek from our group?*What's one thing we should remember about you?*Who referred you to our group?*NameThis field is for validation purposes and should be left unchanged.
