Lead Market Maker | CORE Commitment Form | Axiom Strategic Capital, LLC

THE CORE COMMITMENT FORM

SEIZE THE OPPORTUNITY, CATAPAULT YOUR CAREER, COMMIT TO BEING CORE!

COMPLETE THE CORE COMMITMENT FORM BELOW

Basic Contact Information

Please complete each section as accurately as possible.

Full Name:^*

Email Address:^*

Phone Number:^*

Please explain in detail WHY you are making the CORE Commitment.^*

What specific goals will you use the opportunity of becoming a Lead Market Maker to accomplish?

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Your Personal Network

Enter 5 names of close friends, family, or anyone with whom you have a personal connection.

Provide the first name and relationship of your first personal contact.^*

ex. John Smith - Brother

Provide the first name and relationship of your second personal contact.^*

ex. John Smith - Brother

Provide the first name and relationship of your third personal contact.^*

ex. John Smith - Brother

Provide the first name and relationship of your fourth personal contact.^*

ex. John Smith - Brother

Provide the first name and relationship of your fifth personal contact.^*

ex. John Smith - Brother

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Your Professional Network

List 5 names of colleagues, business associates, or professional connections whom you know.

Provide the first name and relationship of your first professional contact.^*

ex. Jane Doe - Co-Worker

Provide the first name and relationship of your second professional contact.^*

ex. Jane Doe - Co-Worker

Provide the first name and relationship of your third professional contact.^*

ex. Jane Doe - Co-Worker

Provide the first name and relationship of your fourth professional contact.^*

ex. Jane Doe - Co-Worker

Provide the first name and relationship of your fifth professional contact.^*

ex. Jane Doe - Co-Worker

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Your Extended Network

Provide 5 names of contacts outside your immediate network, such as friends living in other locations.

Provide the first name and relationship of your first extended contact.^*