Legacy Leaders Application

LEGACY LEADERS MENTORSHIP PROGRAMS

CONFIDENTIAL APPLICATION
Date

MonthDayYear
Name*

First NameLast Name
E-mail*
Contact Phone Number*

Area CodePhone Number
Birthdate*

MonthDayYear
Company Name:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Please, Tell Us About You
Describe your business and what product/service you provide now or would like to provide.
On a scale of 1 - 10, what is your level of commitment to your business?
If your answer is 0 - 9, what are three (3) things you would be doing differently if you were a 10?
What do you most need to happen in your business right now? What is your opportunity for growth?
Twelve months from now, when you look back at the last year of building your business, what would have had to have happened for you to feel that the year was truly a success?
What was your approximate gross business revenue for last year?
What was your approximate gross revenue for this year?
What is your financial goal for next year?
What is your website?
What is your list size?
What is your social media presence? Please list each social media profile and number of followers.
Being honest, in what areas of your life have you been procrastinating?
What is the greatest outcome you'd like to see from joining this Mentorship?
What were your greatest accomplishments over the last two years?
What is your long term vision for yourself and your company? How BIG are you willing to play?
Who or what is your biggest obstacle in reaching your current goals? What could block you from giving this gift to yourself?
The first 90 days: List 3 short term goals you would like to work on with measurable results for each (Keep these realistic but a bit of a stretch for you).
The next 90 days: List 3 more goals you would like to work on by 6 months with measurable results for each (Keep these realistic but a bit of a stretch for you).
What have you done so far to market your business, reach your big business goals. What worked and what didn't?
What is the biggest opportunity/resource that you're not taking advantage of?
Please list the things you "tolerate" about your business.
Please list all the things that you want to improve, achieve, master or change about your business over the next year.
The Next Few Questions are for When We Work Together
What do you want us to watch out for in coaching with you?
Are you willing to do the agreed upon work, and send the required check-in progress forms?

YesNo
Results are an issue of personal responsibility. Are you ready and willing to make the changes necessary to achieve your goals?

YesNo
What do you want us to do (or not do) if you get behind on your assignments or resist doing some of the work in this Mastermind year? (We're always gentle....don't worry!)
What is the most empowering and helpful thing we can do during your monthly strategy sessions?
Anything else you would like to share with Laura?
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LEGACY LEADERS MENTORSHIP PROGRAMS

The Next Few Questions are for When We Work Together