JV Retreat 2014 Intake Form Program & Name Tag InformationYour name (as you'd like it to appear on your nametag): Your preferred contact email (used to login and make changes): Your city & state: Your main website: The name of your company: Your main role or position in the company: Short bio that would be useful as an introduction to others who don't yet know you: What resources would best support your business?: Share something unique about yourself: Picture of you: (allowed formats are: png, jpg, jpeg, or gif)Feedback For UsThe answers to these questions will not go in your profile, but will help us create the most amazing event for you:What are the biggest challenges you’re experiencing in your business right now? What would make this event a game changer for you?