Form

Email*

First name*

Last name*

Job title*

Agency/Firm name*

Primary Agency Capabilities*

List the primary services you provide in-house for clients.

Desired exit timeline*

0-6 months

6-12 months

1-2 years

2-3 years

3-5 years

Employee count*

Goals as a member*

List your top one to three goals you hope to achieve as a member of The Phoenix Guild

Target Industries*

List the target industry verticals you desire more new clients in

Ideal Clients*

Define your agency's ideal clients

Year founded*

Contact number*

Website URL*