Opportunities & Connections in Entertainment   




Women Helping Women


Membership Application


All Information is Absolutely Confidential


 Required


Date: 11/11/2019









Type of Membership:
Individual
Student
Corporate













Sex:
Female
Male
  Race/Ethnicity:  














Involved in:
Movies
Television
Music
New Media
  Other: 








Number of years in the industry: 





Do you currently earn a living in the entertainment industry: 
Yes
No
Part-Time















Full Legal Name: 





Professional Name: 





Name to apear on membership card: 





Profession: 





     Company Name: 





     Company Type: 





     Your Title: 





Mailing Address: 





     Suite No: 





     City/Town: 





     State/Province: 





     Postal Code: 





     Country: 





Contact Phone 1: 





     Contact Phone 2: 





Email Address: 





Websites and Blogs





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REPRESENTATION:




  Name 1: 

   Agent 
   Manager 
   Attorney 





  Name 2: 

   Agent 
   Manager 
   Attorney 





  Name 3: 

   Agent 
   Manager 
   Attorney 















Membership Affilliations (Unions/Guilds/Organizations)





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CONTACT INFORMATION FOR PUBLICATION


WHW may provide the following checked 
information for distribution to:


Members = WHW Members Only • Public = Others
 (including WHW Members) • Private = Office Use Only






Information
Members 
Public 
Private


Company Name






Work Address






Mailing Address






Representation Info






Websites













Information
Members 
Public 
Private 


Email Address






Work Phone






Work Direct Line






Contact Phone #1






Contact Phone #2
















FOR OFFICE USE ONLY:




Career Objective:





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Special Skills or Expertise:





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Hobbies/Interests:





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Special Awards or Noteworthy Credits:





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List any Professional Connections or Resources you have in Hollywood:





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Why do you want to join WHW?





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What do you bring or intend to bring to WHW and its membership?





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What do you hope or expect to get out of your membership in WHW?





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What was the most recent thing you did to help another woman in the entertainment industry?





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WHW MEMBER INVOLVEMENT:




WHW Member Mentoring Requirement:




WHW members MUST participate in Project Reach Up, Reach Out & Reach Back™, a WHW mentorship program,whereby members commit at least 15 HOURS, in each year that membership is current, to reaching out and mentoring one or more WHW members in need of assistance.




 I would like to be a mentor to (specify e.g., writer, producer, make-up artist, cinematographer, etc.):





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 I would like to: 

 be mentored by and/or  

Intern with:   














 I would like to VOLUNTEER to:





help PLAN/PRODUCE WHW programs/events



secure SPEAKERS for WHW programs/events





secure VENUES for WHW programs/events



secure SPONSORS WHW programs/events





MARKET WHW programs/events



secure MENTORS for WHW membership








start  

head  



be part of a group or subgroup dealing with: (Specifiy area of interest):








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I would like to VOLUNTEER to:




HOST Small WHW programs and events consisting of no more than 
 people at my:



Home 


Office 


  Other: 











HOST/EMCEE  

MODERATE WHW events  

BE A SPEAKER

 PANELIST at WHW events relating to (specify area of interest or expertise):















INTERVIEW influential women I admire for WHW e-magazine and/or other WHW media projects










WRITE articles/features for WHW e-magazine & other WHW projects














WHW EVENTS – MOST WHW events are FREE OR DISCOUNTED to members!!




I would like to attend events featuring speakers on:





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I would like to attend workshops or seminars pertaining to:





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I Can  



I Prefer  



I would like to attend  




Night-Time Events  






I Can  




I Prefer  




I would like to attend  




Day-Time Events  






I Can  




I Prefer  




I would like to attend  




Weekend Events  




Sat 




Sun 








Other (I would like to see WHW get involved in:)





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REFERENCES: PLEASE LIST ONE BUSINESS AND ONE PERSONAL REFERENCE








Name of ReferenceRelationshipPhone (w/area code)


1.










2.
















WHW Sponsor:







I do not have a sponsor. I wish to waive this requirement because:





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I understand that all WHW membership applications are subject to review.


I have read and accept the Code of Ethics and Terms and Conditions for Women Helping Women membership and hereby sign the Member Pledge.



(View WHW Pledge) 



















  

  

    



  
  


  



  
  

  

  Women Helping Women

Hollywood Global Entertainment Network (HGEN)

  (323) 465-9800
    Email: 
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