Hire Us - THE POWERHOUSE

know? the (please

Name

First

Last

Address:

Please provide your City, State/Province, Country

Email

Your preferred email address

Social Media Handles

Instagram, TikTok, YouTube, and Twitch

Tell Us About You! (200 word max)

We’d love to get to know you. What’s your name, your role, and what brings you to our community? What are you hoping to achieve here—networking, learning, or something else? How do you prefer to stay in touch (email, text, etc.)? Tell us a bit about your hobbies, passions, or any special skills you’d like to share. Are you open to connecting with others, volunteering, or mentoring? Lastly, anything we can do to make your experience great, or a fun fact you’d like to share?”

Referral Information

Received an invitation from Sevy M.
Received an invitation from Veno.
Referred by Current Member(s)
I’m a visitor, looking to become a member or have a meeting.

If referred, please list the name of the member who referred you:

Name & Contact

Goals and Interests

Networking and building connections
Professional development and skill-building
Access to exclusive events and experiences
Access to co-working and private spaces
Content creation and brand support
Talent development and management

What are your primary goals in joining PRIVV?

Describe your vision for being part of the PRIVV community

(1-2 sentences):

Current Challenges and Needs

Which tasks or responsibilities would you like PRIVV to handle for you?

Other (please specify):

Current Challenges and Needs

What would a successful PRIVV membership look like for you?

Optional:

Membership Preferences

Free (Join Our Email List) *no referrals required.
250$ annually (The Access Membership)
750$ Lifetime Membership (Available only in 2025)
I’m a visitor, looking to become a member or have a meeting.

Monthly Fee Agreement

I understand and agree to the Free membership fee of $0.
I understand and agree to the Annual membership fee of $250.
I understand and agree to the Lifetime membership fee of $750.
I’m a visitor, looking to become a member or have a meeting.

Invoice will be sent for payment to your email.

Additional Information

Would you like to access any specific PRIVV resources? (Select all that apply)

Any other information you’d like us to know?

Innovation Hub Access – For Members and Visitors Agreement.

Agree
Disagree

Innovation Hub – By entering this space, you agree to maintain the confidentiality of all members, discussions, and shared content. Any information, interactions, or personal details encountered here are private and may not be disclosed or shared outside this community without explicit permission.

APPLICATION – MEMBERS & VISITORS INTAKE FROM.

PLEASE COMPLETE THE FORM BELOW IN FULL.

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