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Fill Out This Short 2-Minute Application to Schedule a Free Discovery Call

 

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Question 1 of 19

What is Your Name?

Question 2 of 19

What is your age range?

(Example: 30's, 40's, 50's etc.)

Question 3 of 19

What have you found to be your biggest struggle so far?

 

And what are some of the things you are hoping to gain from the my coaching program?

Question 4 of 19

If accepted to this coaching program, my primary reason to join is to:

(Select all that apply)
A

Scale-Up My Business/Income

B

Find My True Purpose

C

Make a Bigger Impact In My Niche

D

Improve My Sales/Marketing Skills

E

Gain and Leverage Insights on High Performance, Overall Health and Well-Being, Mental Health, and more

Question 5 of 19

My email and phone number is:

Section 2

Section 2 of 4

Question 7 of 19

The industry I am in is best described as:

 

Question 8 of 19

My current role and position is:

Question 9 of 19

My website Url is (if applicable):

Question 10 of 19

My annual GROSS REVENUE is in this range:

Question 11 of 19

Please CONFIRM and VERIFY the following:

 

If I am accepted to this coaching program, I understand that this is a $5k-per-month investment in myself, my financial growth, and achieving my true purpose.

 

(If this is beyond your budget, you can still press "I accept," as there is also a $3k-per-month option available.

 

And if you're interested, there is also a more immersive $10k-per-month option available as well.)

A

I accept

Question 12 of 19

Have you ever hired a coach before or belonged to a high-level mastermind or networking group?

A

Yes

B

No

Section 3

Section 3 of 4

Question 14 of 19

My single PROUDEST ACHIEVEMENT I made in my life is:

Question 15 of 19

My single most COSTLY MISTAKE I made in my life is:

Question 16 of 19

A “FUN FACT” most people don’t know about me is:

Section 4

Section 4 of 4

Question 18 of 19

On a scale of 1 to 10, I rate myself as follows for each of the following:

A) Personal Ambition

B) Personal Commitment

C) Personal Coachability

D) Willingness to be a Giver

E) Ability to Have Fun While Achieving

F) Respect for "Marketing Skills"

G) Ability to Lead by Example

Question 19 of 19

In one sentence, here’s my top reason why I want to be accepted to this coaching program, as a result of this application:

Confirm and Submit