Registration: Ellivate Immersion (April 2021)

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Please complete the following registration. You will be receive confirmation with 48 hours of submission.

What is your name? *

What is your e-mail address? *

What is your phone number? *

What is your mailing address (include city, state and zip)? **Please provide an address where you can receive a package via USPS.** *

What is the name of your business? *

Confirm the following information regarding your business: *

I am a woman entrepreneur building my own brand and company from the brand up.

Required

Briefly describe your business and offerings. *

Why do you want to attend the Ellivate Immersion? *

What stage of business are you in? *

Emerging – You have an idea and are ready to make it a business, or you started your business in the last 1-3 years.

Evolving – You have an established business (3+ years) and want to build a stronger foundation, reinvent and/or accelerate your growth in a meaningful way.

Embodying – You already have a successful, established business and want to embody what it means to be an evolved, conscious business owner. You want to be part of a powerful collective that gives back and expands our positive impact in the world.

Required

Check the box for each Master Mind session you plan to attend (we hope you attend all 3!), and use the links below to sign-up for your preferred time slot for each of the 3 modules. *

Master Mind session #1 (April 7 or 8) Sign-up here: https://www.signupgenius.com/go/5080b4daaad29aaf49-ellivate32

Master Mind session #2 (April 14 or 15) Sign-up here: https://www.signupgenius.com/go/5080b4daaad29aaf49-ellivate33

Master Mind session #3 (April 21 or 22) Sign-up here: https://www.signupgenius.com/go/5080b4daaad29aaf49-ellivate34

I do not plan to attend any of the Master Mind sessions. (Note: We highly recommend attending these sessions, as they are the best opportunity to connect with other women in your cohort.)

Required

OPTIONAL BONUS: At the end of each module, various members of the Dream Team will host an online, live session so you can get to know them and ask them any questions. These sessions are optional and may be cancelled if there is low interest. Please sign-up using the link below, and feel free to modify your RSVP after reviewing the related on-demand content. *

I have signed up for the Office Hours sessions I would like to attend here: https://www.signupgenius.com/go/5080b4daaad29aaf49-ellivate35

I do not plan to attend any of the Office Hours sessions.

Required

OPTIONAL BONUS: Ellivate Dream Team attorney, Jacqueline Rixen, will be available for 15-minute laser legal consultations on April 20-21. *

I have signed up for a laser legal consultation with Jacqueline here: https://www.signupgenius.com/go/5080b4daaad29aaf49-immersion4

No thanks, I don't need to take advantage of this optional benefit.

Required

How did you find out about the Ellivate Immersion? (If someone referred you, please share their name so we can thank them!)

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