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Apply for an Empowered Leadership Session
To help us know a little more about you, please fill out this 2 min form. This helps us prepare in having a conversation to discover your next best right step to live wealthy.
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1. What's your name?
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First Name
Last Name
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2. What's the BEST email address to reach you?
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example@example.com
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3. What's your phone number?
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Area Code
Phone Number
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4. What time zone are you located in?
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5. What brought you here?
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6. What is your current profession or business?
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7. Tell us more about your profession or business.
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8. How long have you been in practice/business?
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9. Do you have a website? (if so, please share your link)
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10. What is your NUMBER ONE goal? (the thing that is most important to you that will make all the difference)
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11. What are the biggest challenge you feel you have right now as it relates to money, value, and worthiness? (Please be as specific as possible)
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12. What is your current monthly personal income and/or revenue (if you have a business)?
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13. What would you like your monthly personal income or business revenue to be?
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14. Do you have a retirement fund, savings, real estate or other types of investments?
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Yes
No
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15
15. If money and time were no object, how would you want to contribute your gifts in the world?
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16. What uncomfortable or unfavorable emotions do you experience on a semi-regular or regular basis (as it relates to money or wealth)? (check all that apply)
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Anxiousness
Worry
Fear
Guilt
Shame
Anger
Other
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17. Please, elaborate more on those emotions? (Explain as best as you can)
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18. Are you able to financially invest in yourself?
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Yes
No
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19. Are you willing to travel for in-person sessions if necessary?
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Yes
No
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20. What have you tried in the past as it relates to any of your money, wealth, value, worthiness challenges?
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21. Why are you ready to become an empowered leader?
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22. Anything else you want to share?
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