Small Business Powerhouse™ 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
Sign in to Google to save your progress. Learn more
Email *
Full Name *
Your Business Website *
Best email address for Stacy and the team to personally reach out to you? *
Phone Number *
Mailing Address *
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? *
Tell us more about your business(es) and who you serve. *
Describe your current offers or products and price points. What is your best seller? *
What was your total gross revenue for the last fiscal year? *
What is your total gross revenue projection for this year? *
What are your biggest struggles holding you back from creating the business you desire? *
What are your top 3 goals for the next 12 months?  Please include your revenue goal. *
How did you hear about Small Business Powerhouse™ Mastermind? *
Put a check box for everything you currently have in place and are utilizing in your biz... *
What do you hope to get out of this mastermind? *
Why do you think Stacy is the right person to facilitate your mastermind group? *
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™. *
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? *
Clear form
Never submit passwords through Google Forms.
This form was created inside of Stacy Tuschl LLC. Report Abuse