Name
*
Email
*
example@example.com
Do you have a name for the on-line company you want to create?
*
Mobile Number
Briefly describe the product or service that you want to turn into a profitable on-line business.
*
1. Do you have a passion, dream or skill that you want to monetize?
Yes
No
2. Have you tried a "side hustle" in the past?
Yes
No
Too many times to count
3. Do you ever dare to imagine what it would be like to own your own business?
Yes
No
4. Do you have a clear written statement that describes your dream business fully?
Yes
No
I have a million ideas..but not clearly defined
5. Is your current career success a barrier to "starting all over?"
Yes
No
I guess I do feel comfortable and important there
6. Do you want to make a positive impact on the world, while being paid, by making your product or service available to the people you want to serve?
Yes
No
7. Is your product or service something that would be of great value to the people you want to serve?
Yes
No
8. Are you currently "successful" but unfulfilled?
Yes....I guess I've settled
Yes.....but I want so much more
Yes.....but I have so much to give
No. I'm totally fulfilled
9. Are you overwhelmed trying to figure out how to turn your dream into a profitable reality?
Yes, but, I want to figure it out!
Yes, it's just to much for me
No, I believe I could learn
10. Do you want to be in charge of your own economy? Create a legacy?
Yes!! No one else cares more for my success than I do.
No. I'm fine depending on my job.
11. What are some of the mindset blocks that have prevented you from creating your business? Select as many as apply.
I make too much money at my job
I don't understand the techy stuff
I have prestige and respect at my job
I'm too old...it's too late to start over
Honestly? Fear of failing
I don't know where to begin
I couldn't figure it all out on my own
12. Is your current income determined by, and limited by, your employer?
Yes
No
13. If your business was wildly successful because you made a valuable impact on the people you serve, what would change in your world? Select as many as apply
More money on hand
Reduced debt
More travel
Greater ability to give joyously
Pay for education
A better home
Time Freedom
Quit my 9-5
Solid retirement plan
Reduced fears
Buy some "fun" things
Increased sense of security
I could help my family
Other
14. Do other people ever tell you, "You should sell that?" or "I'll pay you if you help me_______?"
Yes
No
15. Do you trust that your current job will always be there for you?
Yes
No
I just never took them serious
16. Have you begun any research into what it takes to create an online business?
Yes
No
17. Did your current career require education degrees, additional trainings, ongoing skill development, mastering new technologies?
Yes
No
NA
18. Do you experience a sense of joy and abundance and achievement and when you imagine yourself living as a crazy-successful business owner?
Yes
No
19. Do you see a way to replace all of the securities that your current career provides, by creating confidence in yourself for making a very successful life?
Yes
No
NA
20. Do you have everything in place for the retirement life style of your dreams?
Yes
No
I have the basics but not enough to support my dreams
21. Who's life would improve as you become a wildly successful personal business owner? Select as many as necessary. )
My spouse
My children
My grandchildren
Extended family
The charity I could support
My place of worship
My community
My eventual employees
The people I currently owe money to
22. Have you waited your whole life to finally create your own destiny?
Yes
No
I never give up on my dream
23. Do you experience joy and excitement when you imagine yourself with total financial freedom?
Yes
No
24. Would you like to model the entrepreneurial life to your family and friends?
Yes
No
25. Are you interested in working with a coach who would walk with you through the entire process, tackling the mindset blocks, learning the skills and implementing the strategies?
Yes
No
I'd like to chat
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