Synergist Database - Contact Information
Please fill out this form to be included in the Synergist Network database. Note membership and hence this database are only open to current, full-time investors.  

Notes:
1. There will be two databases, one shared only with Synergist members with password protection; one shared with Synergist sponsors. You can opt in or out of either database at the bottom of this form.
2. If you would like to update your info in the database, please edit your initial responses. You will receive an email confirmation of your first response including a link to edit.  

Note the email provided here will be used to give you access to the database. Please use a gmail or you will not receive access. Below is an option to put a different preferred contact email. 
Email *
First Name *
Last Name *
Preferred Contact Email *
Phone Number *
If you do not want to provide, please input n/a
Location *
If you are not based in one of our five cities, where are you based?
Firm *
Investing Type *
If your investing type is not listed, what type of investing do you do?
Title (or Equivalent Level) *
Sector Coverage *
Required
Where did you go to college? *
If you got an MBA, where you get an MBA?
Linkedin Link *
Are you a member or past member of a Synergist board? *
Would you like to be included in the Synergist Member Only Database? *
Would you like to be included in the Synergist Sponsor Database? *
This is a list of synergist members shared with our sponsors. The sponsors may reach out to you about potential career opportunities or other opportunities.
Please write "I agree" to the following statement:

I am a current full-time investor and I will utilize this database for positive networking only. I will not include any of these emails in mass emails, distribution lists, or solicitations of any kind.
 *
A copy of your responses will be emailed to the address you provided.
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