WPONext Application

Please fill out the below application if you are interested in becoming a WPONext member and learning more about this program. All required fields are denoted by *.

REQUIRED

Full Name*

REQUIRED

Professional Title (if applicable)

REQUIRED

Business Name (if applicable)

REQUIRED

Email Address*


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REQUIRED

Preferred Phone Number*

REQUIRED

City*

REQUIRED

State/Province*

REQUIRED

Zip/Postal Code*

REQUIRED

Country*

REQUIRED

What is your current or former affiliation to the WPO? Please select all that apply.*






REQUIRED

If you are interested in speaking to WPO chapters or otherwise providing expertise in the WPO community, please select which areas of focus you have expertise in. Please select all that apply.











REQUIRED

Membership in the WPONext requires that the applicant is one of the following:*

  • Current or Former Alumna of a WPO chapter
  • Current or Former Member at Large
  • Former WPO Chapter Member
  • Former WPO Chapter Chair
  • Current or Former WPO Board and/or Advisory Council member

 

By checking the below box, I am agreeing that WPO reserves the right to terminate the membership of any member who provides false or misleading information in connection with her WPO membership application.


REQUIRED

By checking this box, I am agreeing to adhere to the WPO Member Confidentiality Agreement and WPO Member Code of Conduct Pledge (both found HERE) and agreeing that breach of these agreements could result in termination of my membership.*


REQUIRED

By checking this box, I am agreeing to WPO's Code of Conduct (found HERE) and agreeing that breach of this agreement could result in termination of my membership.*


REQUIRED

By clicking this box, I am agreeing that I have carefully read and fully understand all provisions of the WPO In Person Meetings Waiver (found HERE) and freely and knowingly assume the risk and waive my rights concerning liability as described in the waiver.*

REQUIRED

By checking this box, I am agreeing to be contacted via e-mail by WPO.*


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