Business Coaching Application

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This form assists in qualifying potential candidates for Business Coaching

*Please Complete This Form Fully and Honestly, if we are to build a working relationship we need to be upfront on both sides. *

**Each Application Will Be Reviewed And Should You Be Successful Either Myself or My Assistant Will Contact You Via Email Within 48hrs

Email *

Do You Have A Website For Your Business? *

Yes

If Yes To The Above Please State Domain Name/s

Name: *

Country: *

Facebook Profile (If you have one)

Skype ID (If you have one)

What Level Of Experience Do You Have In Business? (Online/Offline) *

Zero

Just Starting Out/I have Ideas But Havent Done Much Beyond That

Started But Little Succes

Started And Some Success

Have Been Working With My Business 6 - 12 Months

Have Been Working With My Business 1 - 2 Years

Have Been Working With My Business Between 2 and 5 Years

Have Been Working With My Business In Excess of 5 Years

Other:

Required

Have You Made Profit In Your Business In The Last Financial Year? If So Roughly How Much? (Please note if your return is Nil/Zero just state - Nil or Zero *

Are You Willing To Sign an NDA (Non - Disclosure Agreement) In Respect To All Information You May Receive Within The Coaching? *

Yes

What Is Your Most Noteable Achievement In Life So Far? *

What Are Your Current Goals Within A Business You Have Already Or Intend To Start? (E.g. What Are Your Financial Goals Within A Certain Timescale? Do You Have A Business Plan in Place? ) *

How Much Capital Do You Have Available To Invest In Your Business? *

Zero

$100 - $500

$500 - $1000

$1000 - $2000

$2000 - $5000

$5000 - $10,000

$10,000 PLUS

If Successful And Accepted For Business Coaching How Ready Are You? *

Ready To Invest Time and if needed a small amount of money In Myself, Business and Future As Soon As Possible

I Want To Think About It Some More Before I Commit

I Do Not Have Money To Invest Right Now

A copy of your responses will be emailed to the address you provided.

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