The SHINE Inner Circle™ Application
Complete this private advisory application to be considered for Dr. Dawn Nicole McIlwain’s corporate-client program.
About You
1. Full Name
*
First Name
Middle Name
Last Name
2. Business Name
*
3. Website
4. Email
*
example@example.com
5. Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
6. Industry Category
*
Please Select
Construction and Skilled Trades
Facilities, Janitorial and Maintenance
Professional and Business Services
Staffing and Human Resources
Technology and IT Services
Marketing, Media and Creative
Logistics, Transportation and Fleet
Food Service, Catering and Hospitality
Manufacturing and Industrial Supply
Products, Merchandise and Retail Goods
Health, Wellness and Safety
Financial and Accounting Services
Security Services
Environmental and Energy Services
Other
7. Years in Business
*
Please Select
Less than 1 year
1 to 3 years
4 to 7 years
8 to 15 years
More than 15 years
8. Current Annual Revenue Range
*
Please Select
Under $250,000
$250,000 to $500,000
$500,000 to $1 million
$1 million to $5 million
$5 million to $10 million
Over $10 million
Your Experience With The SHINE Framework by Dr. Dawn Nicole McIlwain
9. Have you completed the SHINE for Business workbook?
*
Yes
No, not yet
10. Have you attended a SHINE for Business workshop?
*
Please Select
Yes
No
Not Sure
Your Business
11. Describe what you business in 1-2 sentences, including who buys your services/goods
*
12. One Corporate Client You Want a Warm Introduction To and Why
*
13. Corporate Clients or Opportunities you've won to date
*
14. What Has Stopped You From Winning Corporate Clients So Far
*
Your Commitment
15. Can you attend twelve live sessions across six months?
*
Yes
No
Not sure
16. By Session 12, what do you intend to have accomplished?
*
17. Payment preference
*
$10,000 paid in full
Three monthly payments of $3,333.33, payable over three consecutive months (90 days)
Submit My Application
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