Business Entrepreneur Intensive Application

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1. Name*
First Last
2. Address*
Street Address City State ZIP Code
3. Email*
4. Phone*
5. Cell Phone
6. Birthday and Year*
MM slash DD slash YYYY
7. Title or profession?
8. Name of your business, if applicable?
9. Website address if applicable?
10. Do you have your own business at this time and is it successful in your eyes? If you don’t have your own business, do you intend to start one?*
11. List some elements of what a successful business looks like to you?*
12. What do you feel, if anything, is not working in your current business?*
13. Where would you like your business to be in 5 years?*
14. When you think about your business, what gets you excited?*
15. Are you willing to attend every class?*
- Yes
- No
16. Are you willing to do all homework and practice outside of class?*
- Yes
- No
17. Give me a little background about your life at this time? (Personal and Business)*
18. Are you ready to push yourself, and why?*
19. What holds you back or limits you from your dreams at this time, if anything?*
20. Tell me one of your greatest fears, in business?*
21. What four words would you use to describe you?*
22. What do you love to do in your “down” time?*
23. Any other comments you would like to share?
24. Bonus Day: (one-on-one individualized support to address your specific business needs throughout the day from a team of experts)
- Yes
- No
Additional $555 investment.
Consent*
- I consent to my submitted data being collected and stored
Email
This field is for validation purposes and should be left unchanged.

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Business Entrepreneur Intensive Application

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Business Entrepreneur Intensive Application

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Positive Affirmations

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