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Help me to help you
This is a little series of questions that helps me help you. Please take a moment and fill out all the sections. The more you
share the more easier things will be for myself and my team - Johnny Cassell
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Part 1: Your Details
First name
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Your answer
Last name
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Your answer
Phone number
Your answer
Email
*
Your answer
Address 1
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Your answer
Address 2
Your answer
City
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Your answer
State
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Your answer
zip code
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Your answer
Country
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Your answer
Birthday
MM
/
DD
/
YYYY
What's your current occupation?
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Your answer
What's your annual income?
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Your answer
Part 2: Your Socials
Instagram handle
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Your answer
Facebook handle
Your answer
Youtube handle
Your answer
Part 3: How Can We Help?
What is the biggest obstacle you are facing right now that is moving you away from achieving your goals?
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Your answer
What is your current experience to date in developing this area of your life? (How often have you been going out etc)
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Your answer
What are some of your sticking points?
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Falling into the friend zone
Running out of things to say
Approach anxiety
Deep level rapport
Connecting on an emotional level
Poor body language
Developing value
Communicating value
Qualification
Verbal escalation
Physical escaltion
Losing my virginity
Removing unwanted thoughts
Getting over an ex
Building meaningful relationships
Developing a social circle
Exploring different relationship models
Conversation starters
How to dress / style
Online dating
Texting / phone game
first date tips
same night sex
sexual technique / becoming a better lover
reading social situations
reading women / spotting the cues
Approaching in the day time
approaching in the evening
getting a phone number
flaky numbers
mindset issues
Other:
Required
How long have you been living with these issues?
Your answer
What do you think life would look like if you had these issues fixed?
Your answer
Where would you like to be within your social and dating life 6 month from now?
Your answer
How satisfied are you in your social and dating life?
Disatisfied
1
2
3
4
5
Satisfied
Clear selection
How would you like to feel overall in your social and dating life?
Disatisfied
1
2
3
4
5
Satisfied
Clear selection
Now that you've rated yourself today, how does the score make you feel? (optional)
Your answer
How would you rate your ability with women in its current state?
Dissatisfied
1
2
3
4
5
Satisfied
Clear selection
How would you like to feel about your overall ability with women ?
Dissatisfied
1
2
3
4
5
Satisfied
Clear selection
Now that you've rated yourself, how does this score make you feel?
Your answer
How do you rate overall the quality of your past or present intimate relationships?
Dissatisfied
1
2
3
4
5
Satisfied
Clear selection
How would you like to feel in your intimate relationships?
Dissatisfied
1
2
3
4
5
Satisfied
Clear selection
Now that you've rated yourself, how does that make you feel?
Your answer
How much are you willing to invest in order to reach your goals
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Your answer
Part 4: Your Experience
Do you have any experience with our programmes?
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I have read Johnny's book 'Elite Seduction - Actionable tool for Love, Seduction and Dating'
I've attended the Impactful Connection Workshop
I've graduated from the Seven Day Programme
I have completed the Mentorship Programme
I have attended or seen one of Johnny's talks
I have one of Johnny's online products
I don't have experience
Anything else I should know about you?
Your answer
I CONSENT TO RECEIVING EMAILS ABOUT ADVICE, UPCOMING EVENTS, PRODUCTS AND ADVERTISING.
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