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
Email address *
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... *
Required
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? *
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