CBNA Chapter Placement Request Form
Connecticut Business Networking Association (CBNA)
For CBNA Skool Community Members Requesting Chapter Placement
Section 1 — Member Information
Phone Number (SMS Updates)
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Current CBNA Membership Level:
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Current CBNA Membership Level:
Preferred Region (if any):
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Preferred Region (if any):
Section 2 — Business Information
Are you currently accepting new clients?
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Are you currently accepting new clients?
Areas your business serves (select all that apply):
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Areas your business serves (select all that apply):
Do you have multiple businesses or side ventures that may fall under other categories?
Do you have multiple businesses or side ventures that may fall under other categories?
Are you prepared to both give and receive referrals?
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Are you prepared to both give and receive referrals?
Have you previously been part of another networking group (BNI, Chamber, etc.)?
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Have you previously been part of another networking group (BNI, Chamber, etc.)?
Section 3 — Availability & Meeting Preferences
Preferred meeting format:
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Preferred meeting format:
Availability for bi-weekly meetings (Select all that apply):
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Availability for bi-weekly meetings (Select all that apply):
Preferred meeting start time (optional, select all):
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Preferred meeting start time (optional, select all):
How far are you willing to travel for in-person meetings?
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How far are you willing to travel for in-person meetings?
Section 4 — Participation Requirements & Acknowledgment
Members must agree to the following to be placed in a chapter:
1) Attend bi-weekly chapter meetings
2) Engage weekly inside the CBNA Skool community
3) Attend monthly CBNA-wide events (virtual or in-person)
4) Bring guests periodically to help the chapter grow
5) Support chapter activities (mixers, promotions, events)
6) Not request referral fees or finder’s fees
7) Maintain professionalism and follow CBNA’s Code of Conduct
Do you agree to meet the above participation expectations?
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Do you agree to meet the above participation expectations?
Section 5 — Business Category Exclusivity
Do you understand and agree to CBNA’s one-category-per-chapter policy?
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Do you understand and agree to CBNA’s one-category-per-chapter policy?
Section 6 — Chapter Goals
Why do you want to join a chapter? (Select all that apply)
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Why do you want to join a chapter? (Select all that apply)
Section 7 — Leadership Interest
Are you interested in taking on a leadership role within your chapter?
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Are you interested in taking on a leadership role within your chapter?
If yes, which roles would you consider? (Select all that apply)
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If yes, which roles would you consider? (Select all that apply)
Leadership roles require consistent attendance, strong communication, and weekly engagement inside Skool.
Section 8 — 90-Day Guarantee Confirmation
To be placed in a chapter, you must be a VIP member ($99/mo) and agree to the 90-Day ROI guarantee.
By checking below, you acknowledge that the 90-Day ROI guarantee requires:
1) Attending 6 chapter meetings in 90 days
2) Attending 3 CBNA-wide events (in-person or virtual)
3) Posting weekly inside the CBNA Skool community
4) Bringing guests when asked
5) Actively bringing referrals when asked
Do you agree to the membership and ROI guarantee requirements listed above?
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Do you agree to the membership and ROI guarantee requirements listed above?
Section 9 — Final Confirmation
1) Chapter placement is based on availability, industry category, and chapter needs.
2) Placement is not guaranteed, but CBNA leadership will contact me as soon as a fitting chapter is available.
3) I may be contacted by CBNA leadership for placement.
4) I may remain in the Skool community until placement opens.
5) I must be a VIP member ($99/mo) to join a chapter.
6) I agree to uphold the CBNA Chapter Code of Conduct at all times.
Signature (sign full name)
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