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Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
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Which best describes your current employment and entrepreneurial status?
*
Please Select
Full-time entrepreneur / Self-employed
W-2 employee and part-time entrepreneur
W-2 employee planning to start a business
Currently transitioning into entrepreneurship
What industry or type of business are you in?
*
Please Select
Business Consulting / Coaching
Credit Consulting / Financial Services
Real Estate / Investing
Professional Services
Healthcare / Wellness
Beauty / Lifestyle
E-commerce / Retail
Technology / Digital Services
Construction / Transportation
Education / Training
Faith-Based Coaching / Life Coaching
Other (please specify)
Other (please specify)
*
Which best describes your current business stage?
*
Please Select
I have a business idea but have not launched
I recently launched and am building my foundation
I have an established business but inconsistent revenue
I have an established business generating consistent revenue
I'm restructuring, relaunching, or pivoting
I'm ready to scale an established business
Has your business generated revenue? If so, approximately how much revenue have you generated in the past 12 months?
*
Please Select
$0 — Pre-Revenue
Under $25,000
$25,000–$100,000
$100,000–$250,000
$250,000–$500,000
Over $500,000
What is your BIGGEST business challenge or obstacle to growth right now?
*
Business clarity and direction
Creating or improving products, services, and offers
Marketing and attracting qualified clients
Sales, conversions, and consistent revenue
Business systems and operations
Business credit, funding, and access to capital
Scaling and expanding my business
Multiple challenges / Need help identifying priorities
What are your TOP business goals for the next six months?
*
Please briefly describe the results you're working toward and what you would like to accomplish through mentorship.
Have you previously invested in business coaching, mentorship, consulting, or business development programs?
*
Please Select
Yes — Private 1:1 Business Coaching
Yes — Group Coaching or Mastermind
Yes — Business Courses or Training Programs
Yes — Multiple Coaching / Mentorship Programs
No — This would be my first coaching or mentorship investment
How did you FIRST hear about Terri Couser?
*
Please Select
YouTube — Terri Couser, The Credit Expert
Instagram
Facebook
LinkedIn
Patreon / Wealth Warrior Community
Email / Text Message
Referral
Speaking Event / Business Training
Other
Have you previously participated in any of Terri Couser's programs or services?
Business Coaching Strategy Session
From Expert to Income
Credit Consultant Business Blueprint
Wealth on Water Mastermind
Wealth Warrior Patreon Community
Credit Leveraged Lifestyle
Elite 10 Group Coaching
Credit Jumpstart Call
Other
No — I have not participated in any previous programs
If you've previously worked with Terri or participated in her programs, what results, progress, or accomplishments have you achieved?
*
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The 6-Month Private Business Success Mentorship™ is a $20,000 investment, with payment options available. Which best describes your current position?
*
Please Select
I'm prepared to invest $20,000 for the right mentorship opportunity.
I'm interested and would like to discuss available payment options.
I'm exploring mentorship opportunities and need additional information.
I'm not currently in a position to make this investment.
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