Client Application

1

Name* This field is required.

First Name

Last Name

2

Business Name * This field is required.

3

E-mail Address * This field is required.

4

Phone Number* This field is required.

5

Website * This field is required.

6

Are you a Purple Collar Professional? (This means that your profession has both white collar & blue collar roles)* This field is required.

YESNO

7

How many years experience do you have in your profession? (working for yourself and someone else)* This field is required.

8

Years in business for yourself* This field is required.

9

How much do you believe your business can grow? Please provide a $ amount.* This field is required.

10

How many hours do you have to put in each week (all roles & responsibilities)?* This field is required.

11

How much personal time do you have each week? (please enter the number of minutes or hours)* This field is required.

12

Do you take less vacations than you used to take?* This field is required.

YESNO

13

Have you taken on more roles than your original area of expertise?* This field is required.

YESNO

14

Do you have enough staff?* This field is required.

YESNO

15

Do you feel stuck?* This field is required.

YESNO

16

Type a question