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I would like to pursue C12 membership. Please contact me to discuss "next steps." The information below is provided to be helpful in launching this process.

First Name:

Last Name:

Title:

Direct Phone No:

Email:

Company:

Address:

City:

State / Province:

Zip:

Employees:

Annual Sales:

Which of C12 Membership 7 Advantages are most important to you at this time (Check top 3)

Working "On" My Business

Christian Board of Directors

In-Depth Analysis of My Business

Accountability to the Group

Business Coaching

My Business as Ministry

Devotion and Prayer

Accountability to the Group

Please contact me regarding:

C12 Membership

Key Player Membership

Alpha Group Membership

Starting a C12 Group in my area

C12 Business Opportunities

Other (please describe below)

How did you become aware of C12?

Businessasmissionnetwork.com

Business Week Small Biz Magazine

C12 Direct Mailer

CBSnews.com

ChristianPost.com

Fast Company Magazine

Fortune Magazine

Google Ad

Google Search

Inc Magazine

Journal of Christian Coaching

Newsmax Magazine

Referral from Colleague

Success Magazine

Web/Print Article

Web search

WORLD Magazine (print ad, classified, website or article)

Facebook

LinkedIn

Tangle

Twitter

YouTube

Other:

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Other Comments/Questions/Requests:

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“We are not human beings having a spiritual experience. We are spiritual beings having a human experience.” - Teilhard de Chardin

Refund Policy • Nothing in this website constitutes an offer for the sale of a C12 franchise.

The C12 Group, LLC. • 4101 Piedmont Parkway • Greensboro, NC • 27410 336.841.7100

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