Membership OutlineMEMBERSHIPDesign Leadership Network membership is limited to the top performing architects, designers and individuals who hold top positions of qualifying companies serving the design industry. All such individuals must hold the titles of Principal, Founder, Managing Partner, President, Chief Executive Officer, Publisher or Senior Vice President. Membership is by express written approval only, and is valid upon notification of the named individual by the Design Leadership Network.CODE OF CONDUCT All members are accepted and membership is maintained on the good-faith basis of demonstrated professional achievements and personal characteristics. Members agree to abide by Respect for all members in all communications and forums Confidentiality of all information exchanged, whether expressly requested or not No unwanted solicitation for business, personal or charitable reasons 1. Applicant Information(Must be completed by ALL applicants)Name* First Last Name of Company*Address* Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Phone*Cell*FaxEmail* Website* 2. Business Information(to be completed by NEW applicants only)Special area of professional expertise*Number of years at your firm*Choose discipline(s): Architect Designer Landscape Architect Other My Position within the firm: Founder Principal Managing Partner President Chief Executive Officer Publisher Senior Vice President Other My firm or business has: less than 5 full time equivalent employees 6–10 11–20 21+ My firm or business revenue is: <$1.0M $1.0m–$5.0m $5.0m–$10m $10M+ 3. RecommendationsTwo to three letters of recommendation from the following DLN members.DLN Member 1*DLN Member 1 Email* DLN Member 2DLN Member 2 Email DLN Member 3DLN Member 3 Email Upload recommendations Drop files here or I would like to be a member of the Design Leadership Network because: What other industry organizations are you a member of or actively participate in? Please list any awards or honors you have received during your career. Upload exemplars of your work Drop files here or 4. Curriculum VitaeCurriculum Vitae Upload your Curriculum Vitae5. Waiver and Release of LiabilityShould I, the undersigned individual, become a member of the Design Leadership Network (DLN) through the approval of this application for membership, I hereby waive all rights which I may now have or which may accrue in the future against DLN, its respective directors, officers, employees and members (collectively the “DLN Representatives”) and I hereby release and discharge DLN and the DLN Representatives from, and agree to indemnify and hold DLN and the DLN Representatives harmless from and against all liability for any and all actions, damages, causes of action, suits, costs, losses, expenses, claims, demands, and judgments which I now have or hereafter shall or may have, resulting from or arising in connection with my membership in DLN, any activities, functions or events sponsored by DLN or the DLN Representatives, or my travel to, attendance at or participation in any DLN sponsored event or activity.6. Photo and Personal Information ReleaseI understand that each Member’s information, including all membership data, may be used by DLN and incorporated into the DLN databases. I understand that DLN retains all rights to these databases. I understand that DLN may release the Member’s information to DLN members, or as required by law. Unless otherwise stated in writing, DLN may reproduce my name, company name, contact information and photo or likeness in the Directory of Members, including a directory on DLN’s home page. At DLN’s discretion, my photo or likeness may be reproduced in member newsletters and other communications during the term of my membership.7. Membership AgreementBy checking this box and sending this application, I agree that I am registering with The Design Leadership Network and that I have read and understand the Membership Outline and the foregoing provisions. I certify that all information contained in the application is current and accurate. All memberships are individual. Applications submitted/costs are per person.