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The Nexus Club Membership Application

5100 N. O'Connor Blvd, Suite 600 Irving, Texas 75039 | info@thenexusclub.org
Download Membership Application

 

  Applicant Information: Employment Information:
Name*: Current Employer:
Date of Birth: Employer Address:
Phone: City,State, Zip:
Email*:
Position:
Address: Phone:
City,State,Zip Email:
    Fax:
  I would like to serve on the following committees:  
 
First Choice:

Second Choice:

 

Membership

Sponsorship

Grant Funding

Golf

Event Planning

Volunteer

PR/Marketing

Membership

Sponsorship

Grant Funding

Golf

Event Planning

Volunteer

PR/Marketing

 
     
  I am interested in being a member of the Advisory Board of Directors:
  Yes
No
 
     
Payment Method: