Name
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First Name
Last Name
Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email
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Phone
(###)
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How did you hear about us?
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Are you creating a small business for the first time (from scratch) and need some support?
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Please check the box (or boxes) that apply to your situation, so we can get you to your goal.
Are you an established business entity that needs support?
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Please check the box (or boxes) that apply to your situation, so we can get you to your goal!
Are you a working professional or corporate executive who needs support in a '9-to-5 gig'?
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Please check the box (or boxes) that apply to your situation, so we can get you to your goal.
Would you like to have one or more members of our team for media appearances or speaking engagements?
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Please check the box (or boxes) that apply to your situation, so we can get you to your goal
Why This, Why Now?
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Please tell us why you started, or want to start, this business, and why now?
If you’re still in the idea phase, tell us why you want to pursue this idea, and why now?
What Does Success Look Like To You?
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Please describe in detail what a successful outcome for this project would look like to you.
Top 3 Challenges Or Things You Want To Improve?
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Please list the TOP 3 CHALLENGES or THINGS YOU WANT TO IMPROVE? (business, career, or project related).
For each THING, tell us what it is, what you've been doing to try and improve it, and what, if anything, has been working.
How do you typically approach work / projects?
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Below, please choose three phrases / word choices (ONLY 3) that best describe your approach to work / projects?
Your preferred consult style?
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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.
Anything Else You Want To Share?
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