Personal Information
Full Name
*
First Name
Last Name
Phone Number
*
E-mail
*
example@example.com
Instagram Handle / Website (optional)
Professional Background
What industry are you currently in?
*
Beauty / Salon
Coaching / Consulting
Health & Fitness
Fashion / Creative
Real Estate
Other:
What best describes your current role?
*
Business Owner / Founder
Solo Entrepreneur
Employee looking to transition
Other:
How long have you been in business or your current profession?
*
Less than 1 year
1–3 years
3–5 years
5+ years
Financial Snapshot
What is your current average monthly revenue?
*
Under $5,000/month
$5,000 – $15,000/month
$15,000 – $50,000/month
$50,000+/month
What is your target monthly revenue over the next 12 months?
*
Under $10K
$10K–$30K
$30K–$100K
$100K+
Goals & Focus Areas
Which areas are you seeking the most guidance and support in? (select all that apply)
*
Business Growth & Strategy
Operations & Systems
Marketing & Branding
Team Leadership & Hiring
Sales & Client Acquisition
Social Media & Content Strategy
Health, Fitness & Well-Being
Family Balance & Relationships
Personal Growth / Mindset
What are your top 3 goals for the next 6–12 months?
*
What’s currently holding you back from reaching your next level?
*
Have you ever worked with a mentor or coach before?
*
Yes
No
If yes, What worked well and what didn’t?
Why do you feel now is the right time for you to invest in mentoring or coaching?
*
How ready are you to invest financially and energetically into your next level of growth?
*
100% ready — I’m all in
I’m serious but want to understand the options
I’m just exploring for now
If accepted, how soon would you like to get started?
*
Immediately
Within 30 days
In the next 3 months
Is there anything else you’d like Danielle to know before reviewing your application?
*
Submit
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