Full Name

Your Email

Clubhouse User Name

Proposed Room Name/Topic

Please share briefly your preferred subjects to discuss:

Preferred format: Panel, Fireside Chat, Open Discussion, etc.

Preferred dates and times for your room (in EST) - Please be specific with 1st & 2nd preferences

Do you have any co-moderators (highly encouraged)? Please name them and their handles below:

How will you promote your room? Please be specific with your marketing channels

What support(s) do you need from the TLB club for your room?

TLB Session leaders hold weekly coaching and support calls; would you be available to participate (even occasionally) on the calls?
YesNo

LinkedIn Profile:

Instagram Handle:

Twitter Handle:

Short bio, for moderator's introduction:

Who Referred You To TLB?