Mastermind Interest Form
Thank you for your interest in joining one of our Mastermind Communities! Please complete the information below so I can learn more about your desired goals and specific needs.
Please note that by submitting this form, you are expressing interest in learning more about our Mastermind Communities and there is no obligation to officially register.
Additional details about upcoming sessions and registration will be shared via email once we receive your information.
* Required
Client Information
First Name
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Your answer
Last Name
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Your answer
Email Address
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Your answer
Phone Number
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Your answer
Best time to call (Please check all that apply)
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Anytime!
Morning (9:00am-12:00pm)
Lunch-hour (12:00-1:00pm)
Afternoon (12:00-5:00pm)
Evenings (5:00-8:00pm)
Weekends Okay
Required
Current Location
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Your answer
Employer + Title of Role
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Your answer
Mastermind Information
Have you ever participated in a Mastermind group before?
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Yes
No
If you responded yes above, please share more about the program you participated in and your experience. What do you like most (and least)?
Your answer
When do you ideally want to join a Mastermind Community?
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Each new group lasts three months and they start periodically throughout the year based on interest and availability.
Your answer
If you need financial support, please share more about your specific situation and the amount you can afford monthly.
A limited number of scholarship spots are available at significantly reduced rates for individuals in need and each will be reviewed accordingly.
Your answer
Desired Goals + Outcomes
What is your primary interest for joining a Mastermind Community at this time?
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Please check all that apply or add your own option below.
I want to expand my network of like-minded professionals
I can't seem to get started on a specific goal
I need more support and accountability
I'm ready to make and sustain some changes
I am curious about coaching and wanted to try out a group experience
Other:
Required
What issues are you currently facing that you're seeking support for?
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Your answer
Please describe any desired solutions or specific goals more in depth here:
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Your answer
If you are interested in learning more about any other custom leadership solutions, please check all that apply below:
Executive Coaching + Lifestyle Strategy
Organizational Culture Consulting
Team Training + Development
Managing Millennials
Strengths-Based Interventions
Millennial Masterclasses
Other:
Do you have any specific questions I can respond to before you join a Mastermind Community?
Your answer
Please share anything else I should know before we connect here:
Your answer
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