Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Are you creating a small business for the first time (from scratch) and need some support? *

Please check the box (or boxes) that apply to your situation, so we can get you to your goal.

I NEED HELP DECIDING ON MY BUSINESS IDEA

I NEED HELP DEVELOPING MY BRAND CONCEPT

I NEED HELP DEVELOPING MY BUSINESS MODEL

I NEED MARKET DATA & INTELLIGENCE

NO, NONE OF THE ABOVE

Are you an established business entity that needs support? *

Please check the box (or boxes) that apply to your situation, so we can get you to your goal!

I NEED HELP BRANDING MY COMPANY

I WANT TO INCREASE MARKET SHARE

I WANT TO UNDERSTAND CULTURAL TRENDS & ITS IMPACT ON MY BUSINESS

I WANT IDEAS TO CREATE NEW PRODUCTS a/o SERVICES

I WANT TO INCREASE SALES

I WANT TO GENERATE MORE REVENUE

I WANT TO IMPROVE MY TEAM'S ORGANIZATION, WORKFLOW, & PRODUCTIVITY

I NEED HELP MANAGING MY BUSINESS

I WANT TO IMPROVE MY PERSONAL SKILLS AS A LEADER

I NEED HELP HIRING TALENT

I WANT TO CUT COSTS

I NEED GUIDANCE AROUND FUNDRAISING ACTIVITIES

I NEED HELP NEGOTIATING VARIOUS CONTRACTS & BUSINESS DEALS

I NEED GENERAL LEGAL GUIDANCE FOR MY BUSINESS

NO, NONE OF THE ABOVE

Are you a working professional or corporate executive who needs support in a '9-to-5 gig'? *

Please check the box (or boxes) that apply to your situation, so we can get you to your goal.

I NEED PROFESSIONALS TO HEAR MY IDEAS ("SOUNDING BOARD")

I WANT CAREER GUIDANCE ("MENTORSHIP")

I WANT CAREER MANAGEMENT

I WANT ACCOUNTABILITY CHECK-INS ("GOAL PROGRESS TRACKING")

I'M FEELING OVERWHELMED ("BURNOUT SUPPORT")

I NEED HELP NEGOTIATING A RAISE

NO, NONE OF THE ABOVE

Would you like to have one or more members of our team for media appearances or speaking engagements? *

Please check the box (or boxes) that apply to your situation, so we can get you to your goal

KEYNOTE SPEAKING

GUEST LECTURE

PODCAST, RADIO, TV & MOVIE DOCUMENTARY SEGMENTS

PANELS

OTHER SPECIAL EVENTS

NO, NONE OF THE ABOVE

How do you typically approach work / projects? *

Below, please choose three phrases / word choices (ONLY 3) that best describe your approach to work / projects?

I Need It Yesterday

To-The-Point

Take Your Time To Ensure Accuracy

Concise

Perfection

Good Enough

Deep & Thorough

Laser Focus

Slow Is Smooth And Smooth Is Fast

Result-Oriented

Love The Process / System

Busy Is Best

Make It Actionable

Think It Through

Your preferred consult style? *

Please check the box or boxes that apply to your situation, so we can get you to your goal! Note: If you select “teach and guide” please check one or more boxes for your preferred learning style.

I want you to teach and guide me during the process

My learning style is visual direction

My learning style is verbal direction

My learning style is kinesthetic direction ("tactile & experiential")

I'm less concerned about an educational experience - I want to get straight to your team's insights & suggested solutions