Application for Meeting of the Minds

Name*

First NameLast Name
Email*
example@example.com
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Website and/or LinkedIn
Optional
Did someone refer you to us?*
Place their name here so we can thank them! If no one referred you, tell us your favorite superhero's name :).
What's the total, approximate annual revenue of your business(es)?*

$0-$100K$101K-$250K$251K-$500K$501K-$1M$1M - $10M$10M +
What does your company do, and what are your top business goals for the next 12 months?*
We want to ensure that you receive a solid ROI if you're accepted into Meeting of the Minds, and want to see how well our resources align with your needs.
What is/are the biggest obstacle(s) holding you back right now from achieving your professional goals (in marketing, sales, time management, HR, etc.)? *
What mindset shift(s) do you need to experience in order to grow your business exponentially?*
What is the potential ROI for you and your business if you were able to overcome those obstacles and implement those mindset shifts?*
What "Zone of Genius" or subject matter expertise can you contribute to a Meeting of the Minds experience that would help others achieve their goals and succeed at the highest levels?*
What ambitious personal goals are you looking to accomplish in the next few months? *
Examples - running a marathon, hosting a major charity event, performing a 5 minute standup comedy routine, etc...
Is there anything else we should consider when reviewing your application? These can be highlights of past accomplishments, or fun facts you feel we should know.
Who else would you nominate to experience Meeting of the Minds?
Should be Empty: