Influence The Room Application:
A copy of your responses will be emailed to the address you provide. Thank you!
Full Name
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First Name
Last Name
Phone Number
*
E-mail
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example@example.com
Company Name
*
Company Website
*
My highest value is...
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On a scale from 1 – 10, 1 being low and 10 being high, I would rate my overall 2022 business results at a ______
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The ONE GOAL that would change every area of my life if I achieved this ONE GOAL is
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The biggest business goal I haven’t achieved is _________
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In 2022, my business generated the following amount of revenue/income:
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In 2023, I plan to invest the following amount to develop myself or my business:
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Kristi, what I really want most is....
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Submit
Should be Empty: