Small Business Powerhouse™ 2021 Application Form
A 12 Month High-Touch Experience for Entrepreneurs Ready to Attain Exponential Growth.
Thank you for your interest in Small Business Powerhouse™ Mastermind. Please complete the following questions thoroughly and honestly. The more we know about you and your business, the better!
Thank you,
Stacy and Team
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Email address
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Your email
Full Name
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Your answer
Your Business Website
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Your answer
Best email address for Stacy and the team to personally reach out to you?
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Your answer
Phone Number
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Your answer
Mailing Address
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Your answer
Have you ever been apart of a mastermind before? If yes, tell us about that experience. What did you takeaway or enjoy most? Was the mastermind free or paid? Was it a mastermind created by peers or a mentor?
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Your answer
Tell us more about your business(es) and who you serve.
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Your answer
Describe your current offers or products and price points. What is your best seller?
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Your answer
What was your total gross revenue for the last fiscal year?
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$100k or less
$100k-$250k
$250k-$500k
$500k-$1 Million
$1-$5 Million
$5 Million +
What is your total gross revenue projection for this year?
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$100k or less
$100k-$250k
$250k-$500k
$500k-$1 Million
$1-$5 Million
$5 Million +
What are your biggest struggles holding you back from creating the business you desire?
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Your answer
What are your top 3 goals for the next 12 months? Please include your revenue goal.
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Your answer
How did you hear about Small Business Powerhouse™ Mastermind?
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Your answer
Put a check box for everything you currently have in place and are utilizing in your biz...
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Digital course
Group coaching program
Mastermind or Inner Circle program
Membership
Physical product
Team members
1:1 Coaching Program
Funnel
Evergreen webinar
Podcast
Youtube Channel
Facebook Biz Page
Facebook Community
LinkedIn profile
Pinterest profile
Instagram profile
Clubhouse profile
TikTok profile
Other:
Required
What do you hope to get out of this mastermind?
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Your answer
Why do you think Stacy is the right person to facilitate your mastermind group?
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Your answer
If you do not get accepted into Small Business Powerhouse™ Mastermind, are you interested in the Foot Traffic Formula™ program? This program is designed to systematize and scale your business through creating an automated marketing system. Many of our Small Business Powerhouse™ clients come directly from Foot Traffic Formula™.
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Yes
No
Possibly, I need to learn more
Knowing we have a very limited seat count for this program, why do you feel YOU should be one of the ones selected for this group?
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Your answer
Send me a copy of my responses.
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