MASTERMIND MEMBER Application
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Please answer each question as completely as possible to provide us with the best opportunity to work together as you move ever forward to a life of greater abundance.
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Email *
Your Full Name *
Email Address *
Phone Number *
Mailing Address--Number and Street *
City, State, Zip *
Country *
Occupation *
Date of Birth *
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Gender *
Marriage Status *
Please describe how you heard about this Strategic Business Mastermind and why you would like to be a member: *
Please rate your satisfaction with your Business Strategy (Economic/Business Models, Marketing, Sales, Client Success, Legal/Entity Protections, etc.) on a scale of 1 {lowest} to 10 {highest}: *
Please rate your satisfaction with your Branding Strategy on a scale of 1 {lowest} to 10 {highest}: *
Please rate yourself in the following area on a scale of 1 {lowest} to 10 {highest}:  CLARITY--Do you feel you are clear about who you are, what your purpose is, and the direction you want to go? *
Please rate yourself in the following area on a scale of 1 {lowest} to 10 {highest}:  ENERGY--Do you consistently have the mental and physical energy needed to excel, accomplish your goals, and feel motivated and happy? *
Please rate yourself in the following area on a scale of 1 {lowest} to 10 {highest}:  COURAGE--Do you take action and consistently express who you truly are and what you truly think, need, and desire? *
Please rate yourself in the following area on a scale of 1 {lowest} to 10 {highest}:  PRODUCTIVITY--Are you consistently focused and effective, and are you good at minimizing distractions and maintaining priorities? *
Please rate yourself in the following area on a scale of 1 {lowest} to 10 {highest}:  INFLUENCE--Do you feel you have the influence needed in your professional connections, with your family members, and in your social relationships to accomplish your goals? *
What do you do for a living, and why did you choose your career? *
What are your top three goals you are striving to achieve right now? *
What major stressors or challenges are you struggling with right now? *
When you feel your most successful and happy self, what makes you feel that way? *
What would your dream life look like if you could wave a wand and make it happen? *
What has prevented you from living your dream life? *
What goal or dream have you ever given up on or failed at, and what do you believe caused you to stop or fail? *
What 3 big changes would you like to make in your life in the next 12 months? *
What are you most proud of and excited about in your life? *
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