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18
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1
Your Name
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First Name
Last Name
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2
Email
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example@example.com
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3
How do you currently generate income? Check all that apply
*
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Coaching
Consulting
Digital products
A Job
Live Events/Workshops
Speaking
Artist/Performer
Entrepreneur
Management
Other
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4
Give an approximate breakdown of % of income for any you selected.
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5
How Many Are in your Email Database (autoresponder)
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I don't have an autoresponder or do email marketing
1-500
501-1000
1000-5000
5000-10000
> 10000
Other
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6
Best guess - how many social media followers do you have and on which platform; if you know that.
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7
What do you expect this years annual revenue to be if you continue as you are?
*
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< $30,000 - I'm a new company
$30,000 - $75,000 - I'm growing at a good pace
$75,000 - $125,000 - I have or will break the 6 figure ceiling soon
$125,000 - $500,000 - My income is stable and I'm growing rapidly
$500,000 - $1,000,000 - 7 Figures is real to me
Other
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8
What is your major stumbling block to your next level success. What is constantly frustrating you
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9
What is your income goal for next year?
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10
What system do you have in place to handle client referrals internally or from others?
I have this automated in an autoresponder CRM system
I personally call everyone to get a renewal or referral
If I remember I get referrals and testimonials
I never do this it takes too much time
Other
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11
How do you get your leads now (check all that apply)
Sending traffic to landing page
Networking
Speaking Keynote
Speaking Platform Sales
FB or other type of ads
Cold calling or phone discovery sessions
Social media strategies
Podcasting, interviews and telesummits
Webinars or Facebook Live presentations
Other
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12
What do you get really excited about?
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13
Is there a goal you have been trying to achieve? If so, what is that ?
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14
What do you consider is your biggest barrier to the achievement of that goal?
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15
What is your highest level of Administrative Training?
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16
Where is your highest level of Technical Training?
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17
Where are you on your Processing?
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18
Do you have a Field Staff Member assisting you?
YES
NO
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Should be Empty:
Your True Game Questionnaire
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