Step 1 of 4 25% PLEASE NOTE: This process is for those who are 100% ready and prepared to move forward creating a FreedomWorks PMA. If you have questions about the service, are not sure the time is right to begin, or are not prepared to make the required donation, please do not begin your enrollment at this time. There are two steps to the FreedomWorks PMA Service enrollment process: STEP 1: Submit the information requested in the form below. This will be distributed to our entire team to make sure we have a thorough understanding of your situation. STEP 2: Once your information is reviewed (within 24-48 hours), you will receive instructions for completing your enrollment, including submitting your donation. Should you require more than a single sitting to complete the form below, please use the "Save and Continue Later" link at the bottom of each page to save your progress. If you have any questions, please don't hesitate to contact us. Contact InformationFull Name* First Last Email* Phone*Website Mailing InformationStreet*City/Town*State/Province*Postal Code*CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Business InformationWhat is your area of expertise?*What business are you in?*What type of training/experience has prepared you to offer your work to the world? (e.g. education, certifications, mentorships, apprenticeships, other training etc.)Years in business?What products/services do you currently offer?*If applicable, do you manufacture a product or sell other people’s products?What inspired or prompted you to do the work you’re doing?*What do you love about this work?*What problems/issues have you confronted?*How are you currently compensated?* Cash Check Credit Card Crypto Other What agreements, if any, do you currently use with clients? (e.g. written, verbal, electronic)Please upload an example of a client agreement, if available.Accepted file types: jpg, gif, png, pdf, docx, odt, xls, Max. file size: 800 MB.What level of urgency do you have? Are you dealing with any issues that are moving you in this direction? Are there other issues surrounding your work it would be helpful for us to know?* Your Interest in a Private Membership AssociationWhat is your primary reason for moving your work into a Private Membership Association?*Based on your current understanding, what are the major benefits of this choice?*What does “success” mean to you in terms of your work? What is the change you are working towards creating in the world?*Are there new opportunities you are considering for the future of your work? How do you see it growing or expanding?*How did you hear about FreedomWorks?*CommentsThis field is for validation purposes and should be left unchanged.
