VIP Application Form

1
Your Full Name
First Name
Last Name
2
Your Company Name
3
Website URL
4
Email Address
5
Your Mobile Number
6
What type of business do you own / what expertise do you offer?
7
How long have you been in business and/or how much experience of running a business do you have?
8
Are you the main decision maker in your business?
YESNO
9
Is your marketing done in-house, or do you use an agency/contractors?
10
Have you got a team (employees, collaborators, contractors, associates)? If yes, how many?
11
What is the current monthly turnover of the business you'd like to discuss?
Below $10,000 per month
$10k - $20k per month
$20k-$50k per month
$50k - $100k per month
$100k - $150k per month
$150k per month or more
12
What’s not working the way you want it to in your business right now, and how do you think working with me will help?
Huge
Large
Normal
Small
Ok
Ok
Should be Empty: