The 317 Mastermind Member Application
Name
*
First Name
Last Name
Email
*
example@example.com
Best Phone Number to Reach You At:
*
Format: (000) 000-0000.
Birthdate
-
Month
-
Day
Year
Date
How You Learned About The 317 Mastermind
*
Please Select
LinkedIn, FB, IG, YouTube
Google Search
Magazine / Publication
TV / Radio / Podcast
Referral
Invited by Tracy
Referred by Someone
Who can we thank for referring you?
First Name
Last Name
Your Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Back
Next
COMPANY INFORMATION
Company Name
*
Billing Address (leave blank if same as your home address)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Company Website / Social Media URL
*
Industry
*
How long has your company been in business?
*
Please Select
less than 2 years
2-3 years
4-5 years
6-10 years
10+ years
What role do you currently serve in your company?
*
Please Select
Owner, Founder, Co-Founder
CEO, President, VP
Partner or Co-Partner
Manager
Other
Expert
Other
How many people work at your company?
*
Please Select
1 - just me!
2 - 7
8 - 24
25 - 49
50+
% Ownership of Your Company
*
In simplest terms, what kind of business do you operate? Who do you serve?
*
Are you the sole decision-maker or do you have a business partner?
*
I'm it!
I have a business partner
Gross Revenue
*
Please Select
less than $100K
$100K - $300K
$500K - $1M
$1M - 5M
more than $5M
>$5M
Your DESIRED annual revenue 2 years from now?
*
What's the #1 CHALLENGE/OBSTACLE you're facing in your business right now?
*
Which THREE AREAS would you like help with the MOST?
*
Mindset Shift
Sales Systems
Marketing and Advertising
HR and Talent Recruitment
Financials
Risk Management & Compliance
Getting Systems in Place
Exit Planning
Focus & Execution
Mentorship, Collaboration, Support
Other
Back
Next
A LITTLE MORE ABOUT YOU
What would you say are your top 3 PRIORITIES in life?
*
What is the best INVESTMENT you've ever made and why?
*
What are your HOBBIES / INTERESTS? If none, what would you like to explore?
*
Do you have a spouse / significant other / children / pets in your life?
*
What is your #1 STRENGTH?
*
What is your #1 WEAKNESS?
*
One WORD that describes you:
*
Causes you care about: (IE: education)
Back
Next
Confirming The 317 Mastermind is Right for YOU
What is it about The 317 Mastermind that gets you most excited?
*
Which organizations, masterminds, or affiliations do you currently invest in?
*
Please share specific skills/expertise/connections you can bring to the group.
*
If 12 months from now you and 317 Mastermind Founder, Tracy Davison, were having lunch together. Looking back over the last 12 months of your life, you're now celebrating what you feel has been THE BEST YEAR EVER for you...what has to have happened in your business and/or personal life?
*
REFERENCES:
Please provide 2 professional references who can attest to your abilities, accomplishments & integrity.
Reference #1
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference #2
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
CLOSING NOTES:
Almost done!
Please accept my application to The 317 Mastermind. I believe that my application should be approved based on the following qualifications: (Check all that apply.)
*
My business is generating a 6 or 7-figure revenue stream, & I believe there's plenty of room to grow.
I'm ambitious & ready to scale my business...I need to be with other achievers.
I'm humble, teachable & have a sincere desire to share with others.
I'm committed (not just "interested") to authentically bless the lives of kindred-spirit Members who are doing the same for me..
I believe in people, and I believe in the USA.
Other
I agree that NONE of the statements describe me: You are not coachable. You are not confidential. You have a negative mindset. You blame others for your circumstances rather than taking personal responsibility when things don’t go well. You are typically late to meetings. You're happy with the status quo in your business.
*
None of these statements apply to me.
One or more of these statements apply to me.
Which statement best describes your financial situation right now?
*
I HAVE the funds to make this financial investment in my growth.
I have ACCESS to the funds.
I DO NOT have access to the funds.
I understand if my application is approved by The 317 Mastermind Curation Team, I must participate in a Member Orientation.
*
I understand.
I understand that The 317 Mastermind is a very unique alliance of remarkable leaders, and that insider secrets, intellectual property, and sensitive information will be shared. Therefore, I am willing to sign a Confidentiality / Non-Disclosure Agreement in order to protect myself, other mastermind Members, Mentors, and The 317 Mastermind, LLC itself.
*
I understand and agree.
I don't understand.
Today's Date:
-
Month
-
Day
Year
Date
Submit
Should be Empty: