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1

Hi I'm Genevieve. What's your name?* This field is required.

First Name

Last Name

2

Great to meet you! What is your Businesses Called* This field is required.

3

Email Address * This field is required.

example@example.com

4

Please tell me the story of your business. How did it start and who does it help?* This field is required.

5

Thank you for sharing your story. What brings you here today?* This field is required.

6

I value your time and the importance of investments into your business. What are you most looking to achieve for your business?

7

Great, I'd be happy to help you with your goal. To make sure we capture all the sides of your business, do you have any additional entities of your business like courses, a blog, a podcast etc ?* This field is required.

8

What other support would be helpful for you?* This field is required.

Email Marketing

Social Media Marketing

Video and/or Photo

A combination of the above

No other services at the moment

9

Does the $1500 investment work for you at this time?This is a limited time offer and prices will be increasing once bookings are filled.

Yes, I can pay in full

Yes, I want to know payment options

I want to know more about additional services to add to the base package.

I have a few questions

10

What is your ideal launch date?

Date

11

Lastly, let's connect! Please provide your Instagram handle.* This field is required.

12

Disclaimer:

By submitting this application, you acknowledge that completion of this form does not guarantee a discovery call, the availability of services, or the formation of a client agreement. Genevieve Romero Services LLC reserves the right to determine client fit at its sole discretion.
The information provided in this form will be used solely by Genevieve Romero Services LLC to evaluate your inquiry and prepare for a potential discovery call. We will never sell or share your information. Please refer to JotForm's Privacy Policy for information on how form data is stored and processed.
By providing your email address, you consent to being contacted by Genevieve Romero Services LLC through the Western Heirloom Media Co email regarding your submission and related services.