2018-2019 Membership Application

Aggie-Vistage Membership Application and Agreement 2019Member information: Please complete the contact information below. All fields required.

Name (prefix, first, middle initial, last, suffix) Job title

Business phone Cell phone

Name (as you would like it to appear for member recognition) Email (primary)

Date of birth Gender: n Male n Female

Sponsoring Company information

Company name Business description

Company address Important: List a physical address for both USPS and FedEx delivery

City State Zip

Your signature below indicates acceptance of the Membership Terms and Conditions set forth in this Membership Application and Agreement.

XAuthorized signature (required) Date (required)

Title (required)

Print name (required)

Vistage use only: Membership ID

Chair and group information (to be filled in by Chair) ____________________________________________________________________________ Chair name Applicant’s group # Start month (mm/yyyy)

Vistage Worldwide, Inc.Membership Terms and Conditions Agreement1. Effect of agreement: This Membership Terms and Conditions Agreement (“Agreement”) is entered into on behalf of the individual

named on the Membership Application (referred to herein as “You”) and Vistage Worldwide, Inc. (“Vistage”).

2. Acceptance: Submission of a Membership Application by You does not guarantee acceptance as a Vistage member. You will be notifiedof your application status after submission.

3.

a. Undertake best efforts to participate in scheduled Vistage Group meetings;

b. Share experiences, challenges, skills and knowledge with fellow members;

c. Maintain strict confidentiality of all Vistage Group discussions;

d. Immediately disclose any potential conflict of interest issues to your Vistage Group; and

e. Complete a personal profile on my vistage and maintain up-to-date account information.

Additional terms: You agree to the Vistage Terms of Use located at vistage.com/terms, and Privacy Policy located at vistage.com/privacy, as updated from time to time.

Membership Commitments: Upon acceptance as a member, You agree to:

Vistage materials: As a member, You will be given exposure to and other access to utilize Vistage’s methodologies and materials along with other confidential information and intellectual property (“Materials”). You understand and agree that Vistage owns all rights, title and interest, including all intellectual property rights for these Materials.

4.

5.

6. Scope of services: The advice, services and opinions provided as part of the Vistage experience are intended to expand thinking andinspire further exploration but are not to be considered a substitute for professional financial, legal, psychological, medical or otherprofessional advice. Even where Vistage Group members or Chairs may be credentialed as professional advisors, an individualrelationship with such advisors has not been created and should not be relied upon as professional advice. The Vistage experience isprovided “as is” with no warranty of any kind. There is no obligation for members to engage in business transactions with Vistagemembers, Chairs or other Vistage affiliates. Should You elect to engage in such business transactions, You agree that Vistage bears noresponsibility or liability for any losses arising therefrom.

“Now, let’s get down to work.” Bob Nourse

Founder

Our valuesTrust Caring Challenge Growth

Our missionImproving the effectiveness and enhancing

the lives of CEOs and key executives.

Our global reachArgentina

Australia

Brazil

Canada

Chile

China

Germany

Ireland

Malaysia

Mexico

Netherlands

New Zealand

Paraguay

Peru

Singapore

South Africa

Spain

United Kingdom

United States

Uruguay

© 2018 Vistage Worldwide, Inc. All rights reserved. 18_221_5033

Vistage Worldwide, Inc.

4840 Eastgate Mall | San Diego, CA 92121

Ph 800.274.2367

Intl +1.858.523.6800

Fax 858.523.6802

www.vistage.com

Vistage works because of the integrity of our 22,000 members. To ensure you and your fellow members get the greatest benefit from your group, we ask that you participate fully in group meetings, respect group confidentiality and honor the membership commitments outlined above. We are excited about your interest in becoming a member and look forward to helping you make great decisions that benefit you, your company, your family and your community!

Your Satisfaction is Our CommitmentIf you have questions or wish to discuss how we can enhance your member experience, please contact Client Services Toll free: 800.274.2367; Email: ClientServices@vistage.com

We are committed to answering your questions within one business day, Monday through Friday, 7:00 a.m. to 5:00 p.m., PT.