Getting To The Next Level®
Coaching Program Application

What is your primary line of business?*
IT Operations/Services, Manufacturing, Food Service, etc.
Do you operate in (or target) a Vertical Market? And if so, what is it?*
How Many years have you been in business?*
How many full time employees do you have?*
Including Admins, Sales, etc.
What is your most recent Annual Gross Revenue?*
Full year, Jan. 1 to Dec. 31
What would you like your Annual Gross Revenue to be?*
Full year, Jan. 1 to Dec. 31
What is your current monthly gross Profit/Loss?*
About how much money are you making or losing every month?
What would you like your monthly gross Profit to be?*
About how much money do you think you should be making every month?
Please share with me what you think the next level look like?*
Tell me what are you ideal goals, what would you like to accomplish, where would you like to be, for the coming quarter, or the coming year?
Please tell me how I can help you get to the next level*
What do you need help with most - What would be the main subject(s) of our strategy session?
What most influenced your decision to complete this application today and reach out to Me for a strategy session?*

Name*
First Last
Your Role with the Company*
The Name of Your Business*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Enter Email Confirm Email
How did you learn about me?
Were you were referred by someone or have we met at an event, etc.?
Is there anything else I should know when considering your Application and request for a Strategy Session?

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