Mailchimp Survey

PROGRAM APPLICATION

Congratulations on your decision to invest in yourself and your future! Please answer the following questions honestly, and with as much detail as possible. All applications are reviewed within 48 hours.

What is your full name?
*
What is the best email address for you?
*
Where are you located?
*
Please provide a link to your business website.
*
In a few sentences, tell me a bit about your business and what you do.
*
How long have you been in business?
*
What is your current annual revenue? What is your annual revenue goal in the next 12 months?
*
What is the #1 goal you want to focus on during this coaching program?
What is the biggest challenge holding you back from where you want to be in your business?
*
What do you hope to experience working with me?
*
I am really good at these things in business...(list at least 3 things).
*
I really struggle with these things in business...(list at least 3 things)
*
Have you worked with a coach in the past? What value did you receive from it?
*
Why do you wish to participate in this program, and why NOW?
*
Expectations: As your coach, I cannot wait to serve you! My expectation is that you are ready to take action, ask questions, and let out some emotions if need be. You are willing to break through and learn how to emerge as your own hero. In order to be considered for this program, please check to indicate your agreement to the following things:
*
I am ready to show up fully and do the work required to grow my business.
I am committed to showing up to every scheduled session, and being fully present & coachable.
I understand that acceptance into this program is an investment in the growth of my business.
I have carefully considered all of my obligations, and I am able to fully invest in myself at this time.
The investment for this six-month coaching program is $10K. Do you have the ability to invest right now should you be accepted?
*
YESMaybe / Not SureNo - but I will find a way!
Is there anything else I should know before we meet?
*
Who can I thank for referring you to Rebekah & Co.?