Member Prospect Information Three-To-Free

Referring Member Information

Referrer First Name *

Referrer Last Name *

Referrer Email *

Referrer Phone *

Prospect Information

First Name *

Last Name *

Phone *

Email *

Relationship to Prospect *

Has an Initial Discovery Conversation Occurred?

Prospect’s Primary Interest (Select All That Apply)

Notes from Initial Conversation

Request MIA Staff Support? *

Yes

Type of Staff Support Needed

Referral Ownership Acknowledgement

I acknowledge that I am the referring MIA member and will remain responsible for leading the discovery and nurture process. I understand that staff support does not transfer referral ownership.

I understand referral credits are issued in arrears and only after enrollment and payment are completed.

TICKETS

SECURE MY SEAT

$397

LIVE SEAT INCLUDES:

Full Access to 2 DAYS Of Amazing Content with Incredible Speakers and Panel Discussions

Full Access to Valuable In-Person Networking, Exhibits, and Sponsors

Incredible Networking Lunch on Saturday

Incredible Networking Lunch on Sunday

VIP ONLY Meet & Greet with Key Speakers

Best Seats Available with Networking & Learning

Exclusive Access To VIP Diamond Party Friday Evening

Welcome Event Bag with Savings & Special Gifts

SECURE MY SEAT

$597

SECURE MY SEAT

$1197

SECURE MY SEAT

TICKETS

PURCHASE TICKETS FOR

THE LOWEST PRICE

SECURE MY SEAT

$397

Full Access to 2 DAYS Of Amazing Content with Incredible Speakers and Panel Discussions

SECURE MY SEAT

$297

Back of the Room Access to 2 DAYS Of Amazing Content with Incredible Speakers and Panel Discussions
(Lunch not included)

SECURE MY SEAT

$597

Full Access to 2 DAYS Of Amazing Content with Incredible Speakers and Panel Discussions
Full Access to Valuable In-Person Networking, Exhibits, and Sponsors
Incredible Networking Lunch on Saturday
Incredible Networking Lunch on Sunday

SECURE MY SEAT

$1197

Full Access to 2 DAYS Of Amazing Content with Incredible Speakers and Panel Discussions
Full Access to Valuable In-Person Networking, Exhibits, and Sponsors
Incredible Networking Lunch on Saturday
Incredible Networking Lunch on Sunday
VIP ONLY Meet & Greet with Key Speakers
Best Seats Available with Networking & Learning
Exclusive Access To VIP Diamond Party Friday Evening
Welcome Event Bag with Savings & Special Gifts

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You are solely responsible for your own decisions, actions, and outcomes. By registering or participating, you acknowledge and agree that you will not hold us liable for your decisions, actions, or results, under any circumstances.