Visionary Leadership Mastermind Application
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
LinkedIn Profile Link
Your Current Title / Role
*
Organization / Company Name
*
How did you hear about the Visionary Leadership Mastermind?
*
Melissa Agnes (directly)
Crisis Ready Institute
Referral from a colleague
Morning Lives with Melissa Agnes
Previous Crisis Ready® program
Melissa's newsletter
Cold email
Other
What's driving you to apply for this program right now?
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Which statement resonates most with where you are today? (Select all that apply)
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I feel like I'm leading with only part of my power
I'm exhausted from trying to control outcomes instead of creating from possibility
I sense there's a deeper way to lead but haven't found it yet
I want more ease AND more impact—not one at the expense of the other
I'm ready to do the inner work, not just learn new tactics
I feel isolated at my level of leadership
I know I'm meant for more, but I'm stuck in probability thinking
Other
What's your biggest leadership challenge right now?
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What would success look like for you 12 months from now?
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Are you prepared to commit to the full 12-month program, including: Weekly live sessions (Wednesdays, 11am ET), Integration practices, In-person retreat, Doing the inner work required for transformation
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Yes
Not at this time
Which experience are you most interested in?
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Core Mastermind
Premium Mastermind (with monthly 1:1s)
I'd like to discuss both options on the discovery call
The investment for VLM ranges from $25K-$50K for 12 months. Are you prepared to make this level of investment in yourself?
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Yes
No
I'm not sure yet
What questions do you have about the program that would help you make your decision?
Is there anything else you'd like Melissa to know about you or your leadership journey?
By submitting this application, you understand that:
This is an application, not an enrollment
If accepted, you'll be invited to schedule a discovery call with Melissa or her team
The program is by invitation only to ensure alignment
SUBMIT APPLICATION
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