NEW MEMBER APPLICATION

Questionnaire

Step 2 of 2

Answer this questionnaire to complete your application

Question 1 of 15

Date Of Birth

Question 2 of 15

Years in Business

Question 3 of 15

Number of Staff/Virtual Assistants

Question 4 of 15

Name of Your Business & Website

Question 5 of 15

Average Annual Revenue (Last 3 Years)

Question 6 of 15

Estimated Net Worth

Question 7 of 15

How Much In Your Survival Account Today?

Question 8 of 15

Spouses Name (If applicable)

Question 9 of 15

Children's Names and Ages

Question 10 of 15

Other Important People In Your Life

Question 11 of 15

What Are You Hoping To Gain From A Coaching Program?

Question 12 of 15

How Do You Intend To Contribute To A Coaching Program?

Question 13 of 15

What Are The Two Big Things You'd Like to Accomplish in the Next 6 Months?

Question 14 of 15

On a scale from 1-10, with 1 being the easiest and 10 being the most aggressive, how hard do you want to be coached to reach your goals?

Question 15 of 15

Which Coaching Program Are You Applying For?

Level 1 Coaching and Mastermind Group - $29/mo

Black Belt Coaching Team - $497/mo

One on One Coaching - $997/mo

(Select all that apply)