Full Legal Name (Required)
Preferred Name
Email Address (Required)
Mobile Phone Number (Required)
City (Required)
State (Required)
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Alabama Alaska Arizona Arkansas
California Colorado Connecticut Delaware
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LinkedIn Profile URL
Company Name (Required)
Company Website
Industry (Required)
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Construction / Trades
Professional Services
Technology
Healthcare
Real Estate
Manufacturing
Finance
Retail / E-Commerce
Hospitality
Nonprofit
Education
Media / Marketing
Transportation / Logistics
Other (Write-In)
If you choose “Other”, a field will appear.
Industry (Other)
Current Role (Required)
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Founder / Owner
Co-Founder / Partner
CEO
President
Executive Leadership (C-Suite)
Director / VP
Senior Manager
Entrepreneur (Early Stage)
Investor
Other (Write-In)
Role (Other)
Years in Business (Required)
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Pre-Revenue
0–1 Years
2–5 Years
6–10 Years
11–20 Years
21+ Years
Number of Employees (Required)
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Just Me
2–5
6–15
16–50
51–100
101–250
251–500
501–1,000
1,001–5,000
5,001+
Annual Revenue Range (Required)
Select…
$0 (Pre-Revenue)
$1 – $100,000
$100,001 – $250,000
$250,001 – $500,000
$500,001 – $1 Million
$1 Million – $2.5 Million
$2.5 Million – $5 Million
$5 Million – $10 Million
$10 Million – $25 Million
$25 Million – $50 Million
$50 Million – $100 Million
$100 Million – $250 Million
$250 Million – $500 Million
$500 Million – $750 Million
$750 Million – $1 Billion
$1 Billion – $1.5 Billion
$1.5 Billion – $2 Billion
People depending on you daily? (Required)
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Just Myself
1–10
11–25
26–50
51–100
101–250
251+
Primary leadership responsibility (Required)
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Strategic Vision
Revenue & Growth
Operations
People & Culture
Financial Oversight
Sales Leadership
Multiple Areas
Other (Write-In)
Primary Responsibility (Other)
Biggest current leadership challenge (Required)
Current spiritual rhythm (Required)
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Consistent and Strong
Growing but Inconsistent
Rebuilding / Restarting
Exploring
Prefer Not to Answer
Connected to a local church? (Required)
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Yes
No
In Between
Do you have accountability? (Required)
Select…
Yes
No
Occasionally
Strengthening Area (Other)
Why do you want to join FBL? (Required)
What are you hoping to gain from FBL? (Required)
What are you willing to contribute to members? (Required)
FBL is built on contribution, not consumption. Consider your experience, network, skills, resources, or wisdom. This is not a spectator network. Examples: mentoring, strategic insight, capital access, hiring opportunities, prayer, operational expertise, marketing support, accountability, leadership experience, industry knowledge. How can you actively serve, support, or strengthen other members?
MEMBERSHIP TIER INTEREST (REQUIRED)
Tier 1 (Builder Tier): Businesses and entrepreneurs under $1,000,000 in annual revenue.
Tier 2 (Leader Tier): Businesses and entrepreneurs above $1,000,000 in annual revenue.
Select…
Builder Tier (Tier 1 - Under $1M)
Leader Tier (Tier 2 - Above $1M)
Chapter Leadership Interest
Exploring / Not Sure Yet
MEMBERSHIP PAYMENT SELECTION (REQUIRED)
Acknowledge the one-time assessment fee, then select Tier + plan. Totals auto-calculate and are included in the email.
I acknowledge the one-time assessment fee required for onboarding and membership activation.
You must acknowledge the one-time assessment fee to proceed.
Select Years (Upfront)
Choose…
1 Year
2 Years
3 Years
4 Years
5 Years
Choose 1–5 years for upfront payment.
3+ years: uses the 3-year monthly rate for the selected tier and multiplies by 12 × years.
Assessment Fee
$0.00
Selected Monthly Rate
$0.00
Membership Total (Selected Plan)
$0.00
Estimated Due Today
$0.00
How this calculates:
Monthly → Due Today = Assessment + 1st month
Upfront → Due Today = Assessment + (Monthly Rate × 12 × Years)
By submitting this application, I affirm that I am pursuing leadership that integrates faith, work, and life,
and I understand that membership requires integrity, accountability, and alignment with the FBL Covenant.