Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Number of Employees

Me

Myself and One Other

<5

<10

<100

>100

How long have you been in business?

< 1 Year

1 to 3 Years

3 to 5 Years

> 5 Years / Feels like Forever

Which membership package?

Desk Hop Mini

Desk Hop Maxi

Desk Hop Turbo

Weekend Warriors

Mini Meeting Rooms

Meeting Den

Use of Griffin Co-Working *

Tick as many as appropriate

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Ad Hoc

Morning

Afternoon

Need to bring a Guest