Mastermind Application Form
Contact Information
Full Name
First Name
Last Name
Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business / Venture Name
Website
LinkedIn Profile
Assistant Name ( Optional )
Assistant Email ( Optional )
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Your Vision, Business & Impact
Tell us about your business and / or investment focus.
What stage are you in? What are you building? Who do you serve?
How is your business and / or investments making a difference in the world?
Share the deeper mission or impact behind your work.
What do you think are the top 3–5 most important things you need right now to scale?
What excites you most about being part of a mastermind with aligned, purpose-driven leaders?
What would you hope to gain?
If you joined the MAD Mastermind, how would you define success 12 months from now?
What would need to happen in your business and life?
What are 2–3 of your biggest wins or milestones in the last 12–24 months?
What’s the greatest outcome you’d love to see come from joining the MAD Mastermind?
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Commitment & Fit
Are you ready and able to commit the time, energy, and capital to fully engage with the MAD Mastermind for 12 months?
Yes, absolutely
I’m not sure yet – would like to discuss
If selected, how do you plan to pay?
$20,000 AUD upfront
$2,000 AUD/month (+ GST) for 12 months
This mastermind is designed to stretch, support, and challenge you. Are you willing to both receive and give support, insight, and value to others in the group?
Yes
No
Upload any supporting materials here such as: Investor Deck, Financials, IM, etc.
Browse Files
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Is there anything else you’d like to share with us?
(This could be something personal, professional, or just a feeling in your gut about why this is the right time.)
Submit
We look forward to reading your application and possibly building something extraordinary together.
Once we receive your application, we’ll review it personally and contact you if you're shortlisted for a follow-up conversation. Only 10 spots are available.
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