Grounded: Business Clarity — Registration & Baseline Form
Thank you for registering your interest in the Grounded: Business Clarity workshop series. This short form helps us understand your current situation and ensures the program is relevant and valuable for you. All responses are confidential. Anonymised data may be used for program evaluation and reporting purposes. - Please note there is only 15 participants in this Workshop series. To secure your spot enroll today. This Workshop is brought to you by Pyrenees Shire Council.
Your Details
Full Name
*
Business Name
*
Email Address
*
example@example.com
Phone Number
*
Business Profile
Industry / Business Type
*
Trades (e.g. plumbing, electrical, building)
Hospitality (café, restaurant, winery)
Retail
Professional services
Health / wellness
Agriculture / primary production
Other
Years in Business
*
Less than 1 year
1–3 years
3–5 years
5–10 years
10+ years
Approximate Annual Turnover
*
Under $100k
$100k – $300k
$300k – $750k
$750k – $1.5M
$1.5M+
Current Business Position (This Financial Year)
*
Profitable
Breaking even
Not currently profitable
Unsure
Number of People in Business (including yourself)
*
Just me
1–2
3–5
6–10
10+
Current Situation
How would you describe your current role in your business?
*
What best describes your current situation?
*
Feeling overwhelmed or stretched
Struggling with financial clarity or cashflow
Unsure what to prioritise
Constantly reacting or putting out fires
Working too many roles myself
At a crossroads in the business
Finding it difficult to switch off from work
Other
Other
On average, how many hours of sleep are you getting per night?
*
Less than 5 hours
5–6 hours
6–7 hours
7–8 hours
8+ hours
How many hours per week are you currently working in your business?
*
Under 30 hours
30–40 hours
40–50 hours
50–60 hours
60+ hours
How many hours per week do you work ON your business rather than in it
*
0
1-2
3-5
5-10
10-15
15-20
20-25
What Business support structure do you currently have in place
*
None
Admin
Accountant
Bookkeeper
Office Manager
Supervisor
Operations Manager
General Manager
CFO
Estimator
Day Manager
Other
Other
What is your biggest challenge in your business right now?
*
What are you hoping to get out of this workshop?
*
Baseline Self-Assessment
This is not a test - honest self-reflection is most helpful
Financial Clarity: How clear do you feel about your business finances? (1 = least clear, 5 = most clear)
*
1
2
3
4
5
Decision Confidence: How confident do you feel making business decisions right now? (1 = least confident, 5 = most confident)
*
1
2
3
4
5
How do you feel about your business? 1 = very overwhelmed, 5 = calm, clear and in control
*
1
2
3
4
5
Workload Alignment: How aligned does your current workload feel with what actually matters? (1 = least aligned, 5 = most aligned)
*
1
2
3
4
5
Mental Capacity / Headspace: How much mental space do you currently have to think clearly? (1 = least mental space, 5 = most mental space)
*
1
2
3
4
5
Consent
*
I understand that anonymised data from this program may be used for evaluation and reporting purposes.
Submit
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