The Brand Rebirth Application

The Brand Rebirth Application

Once we receive your application, we’ll review it with great care. If we feel aligned, we’ll invite you to schedule a private 1-hour Brand Rebirth Consultation via Zoom.
Full name*

First NameLast Name
Birth Date*

DayMonthYear
Address*

Street Address

Street Address Line 2

CityState

Post CodeCountry
E-mail*
example@example.com
Phone Number*
How did you hear about us?
Would you like to add accommodations at Hold Space Dayton to your package? Staying on-site makes your Brand Rebirth experience more immersive and easeful—no commuting, whether you’re traveling from out of town or you’re a Dayton local. Accommodations include your own private bedroom with a queen sized bed, shared bathroom, and access to kitchen and living spaces, all within walking distance of the historic Oregon District. (If you’re unsure, no worries—you’ll have the option to upgrade later.)

Yes, I’d like to add accommodationsNo thanks, I’ll commute.Not sure yet—can I get more info when we have our interview?
Business Details

In order for us to best serve you to the highest degree and make the most our time together during our consultatiton, please answer the following questions. All answers will be kept strictly confidential.
In a few sentences, tell me a little bit about you and your business or intended business. Please include your official business name, all associated URLs, and social media handles.
What is your current monthly gross income? If it fluctuates, please give an approximation. (If you do not currently own a business, please write NA)
What is your current monthly net profit? If it fluctuates, please give an approximation. (If you do not currently own a business, please write NA)
What financial intentions do you have for your business or intended business that you are committed to creating within the next 6-12 months? (Please share your desired personal monthly income. This number should be just outside the realm of what you think is realistic.)
How long have you been actively working on creating this new level of financial abundance or business growth?
What specific actions have you taken within the past 4-12 months in order to create your desired income level or business growth?
What obstacles or roadblocks have you faced within the past 4-12 months that have hindered you from achieving your desired business results?
What are three brands that you love and why?
Why this project? Why now? What inner or outer shift is nudging you to bring this project to life now?/What’s motivating you to take action on this project now?
We would love to know you better. In a few sentences, please tell us a little bit about your relationships, your personal religious or spiritual beliefs (if any), your current financial situation, something you love about yourself, and and your favorite hobby!
On a scale from 1-10, how committed are you to taking the action necessary to create your new desired business results? (1 being not committed, 10 being fully committed)
We like to bring our intuition to these calls because it allows us to hone in on exactly what YOU NEED much faster. Do we have your permission to use our intuition to make sure this is the best, most transformational experience possible? (If not, no worries. This conversation will be highly transformative for you either way.)

Yes, I give permissionNo, I decline permission
By submitting this form, you agree to Boss Less Babe More to contact you to schedule your Brand Rebirth Consultation. Which contact method do you prefer? Please pick one. (We will be contacting you within 48 hours of your form's submission).

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