6 Month Small Business Turnaround Coaching Program Application
This coaching program is for serious small business owners who are ready to fix their structure, clean up compliance issues, and position their business for funding and growth. Complete this application in full. Incomplete applications will not be reviewed.
APPLICANT INFORMATION
Full Name
*
Full name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
City and State
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
BUSINESS INFORMATION
Legal Business Name
*
Business Website or Social Media Page
If you do not have a website, share your main social media link.
Business Industry or Type
Entity Type
Please Select
Sole Proprietor
LLC, S Corporation
C Corporation
Nonprofit
Other
Do You Have An EIN
Yes
No
I am not sure
How Long Have You Been In Business
Less than 6 months
6 to 12 months
1 to 3 years
Over 3 years
Business Address On File With The State
List the address you use for your Secretary of State or corporate registration.
CURRENT REVENUE AND NUMBERS
What Is Your Current Average Monthly Revenue
Under 2,000 dollars per month
2,000 to 5,000 dollars per month
5,000 to 10,000 dollars per month
10,000 to 20,000 dollars per month
Over 20,000 dollars per month
What Was Your Approximate Total Revenue In The Last 12 Months
Do You Currently Have Any Business Funding Or Business Credit Cards
Yes
No
If Yes, Please Describe Your Current Business Funding Or Credit Lines
READINESS AND FIT
What Is Your Biggest Business Challenge Right Now
Why Do You Feel This 6 Month Coaching Program Is A Good Fit For Your Business
*
What Would A Successful 6 Months Look Like For You
How Many Hours Per Week Can You Realistically Commit To Working On Your Business During This Program
2 to 4 hours per week
5 to 7 hours per week
8 to 10 hours per week
Over 10 hours per week
Are You Willing To Attend Live Coaching Sessions And Complete Assigned Action Steps
Yes
No
How Did You Hear About This Program
Instagram
Facebook
Email
Referral
Other
Final Agreement
*
I confirm that the information provided is accurate to the best of my knowledge.
I understand that submitting this application does not guarantee acceptance into the program.
Submit
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