Work With Me Questionnaire
Please take a few moments to fill out this form so that I can find out more about you
Name *
Email *
Phone number *
Skype name
Website
How did you hear about me?
Are you currently subscribed to my newsletter? If not would you like to be added? *
What is your current situation with marketing and publicising your business? What are you struggling with? Is there anything overwhelming you? *
How is this issue affecting you, your business, and finances? *
If I waved a magic wand, what would you love to achieve in terms of marketing and publicising your business? *
What are your goals over the next 6 months and what would accomplishing these achievements mean to you? *
What are your biggest challenges in achieving your goals?
On a scale of 1-10 (10 being highest) how committed are you to reaching your goals?
Please enter a value between 0 and 10.
Have you had any kind of press or media coverage for your business in the past? If so, where?
Working with Dina on a 1-2-1 basis is a minimum of a four-figure investment (pay-in-full and payment plan options are available). Are you ready to invest in your business?
Clear selection
Are you ready to take action NOW?
Clear selection
Anything else you'd like to add?
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