Booking Form

1

Which best describes your BUSINESS?* This field is required.

I own a local business

I own an ecommerce business

I own a service based business

2

Please enter your NAME:* This field is required.

First Name

Last Name

3

Your best EMAIL address:* This field is required.

example@example.com

4

Mobile/Cell PHONE number:* This field is required.

5

List all your top SOCIAL MEDIA ProfilesType them in one by one. Eg: https://www.linkedin.com/in/camjroberts/ + https://www.instagram.com/cam.j.roberts/

6

Please enter your WEBSITE URL:* This field is required.(If you don't have one, please type "none")

7

Which one best describes your average monthly recurring revenue:* This field is required.

$10k/month or less

$10k-$25k/month

$25k-$50k/month

$50k+ /month

8

What is your monthly RECURRING REVENUE goal?* This field is required.

9

What's your #1 CHALLENGE right now?* This field is required.

10

Inital thoughts - if you created a course, what would it be about?* This field is required.

11

If you qualify for the Influencer Impact, how soon can you start?* This field is required.

I can start now

I can within the next 2 weeks

I can start within the next 4 weeks

12

How many followers do you have across all platforms?* This field is required.

Under 100k

Between 100k-500k

Between 500k-1M

Greater than 1M