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MASTERMIND MEMBER Application
© 2023 Beth Strange LLC. All rights reserved. Removing or repositioning this copyright notice is expressly prohibited. These materials are provided solely and exclusively for the expressed recipient. Any reproduction, transmission, or distribution of this work in whole or in part by any means is expressly prohibited.
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
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Your email
Your Full Name
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Email Address
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Phone Number
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Mailing Address--Number and Street
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City, State, Zip
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Country
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Occupation
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Date of Birth
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Gender
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Marriage Status
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Please describe how you heard about this Strategic Business Mastermind and why you would like to be a member:
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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}:
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Please rate your satisfaction with your Branding Strategy on a scale of 1 {lowest} to 10 {highest}:
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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?
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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?
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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?
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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?
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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?
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What do you do for a living, and why did you choose your career?
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What are your top three goals you are striving to achieve right now?
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What major stressors or challenges are you struggling with right now?
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When you feel your most successful and happy self, what makes you feel that way?
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What would your dream life look like if you could wave a wand and make it happen?
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What has prevented you from living your dream life?
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What goal or dream have you ever given up on or failed at, and what do you believe caused you to stop or fail?
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What 3 big changes would you like to make in your life in the next 12 months?
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What are you most proud of and excited about in your life?
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