AJ Simmons Mentorship Program

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Secure Application for AJ Simmons Mentorship*** LIMITED TO ONLY 8 CLIENTS AT A TIME *** Fill out this form if you are serious about learning/working with me JOIN THIS 8 WEEK MENTORSHIP SESSION WITH ME, AJ SIMMONS! WE WILL FIGURE OUT YOUR ISSUES, DEFINE CLEAR GOALS, MAP OUT A PLAN TO ACHIEVE THOSE GOALS, THEN EXECUTE WHILE DOCUMENTING THE ENTIRE PROCESS!

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Please enter your full name:* This field is required.

First Name

Last Name

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Business Status* This field is required.

Not started yet

Active in business

Started, but not active

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Give some brief details of your current business structure?* This field is required.

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What is the monthly goal you want to hit? (5k month, 10k month, 20k+?...)* This field is required.

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What are your biggest barriers in life?* This field is required.

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What motivates you-- WHY do you actually want to make more money?* This field is required.(Use the space below to give us your reasons WHY)

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What do you want to get out of this program most?* This field is required.(Tell me what you're most interested in learning from me)

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If you are told to re-invest in your business, are you willing to produce the funds necessary to do so?* This field is required.

Yes

No

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Do you agree to have all of our 1 on 1 sessions recorded to be used for training and promotional purposes?* This field is required.Answering "no" to this question may disqualify you from particiation

YESNO

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Please enter your phone number:* This field is required.

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Please enter your email address:* This field is required.

example@example.com

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Instagram Handle?Optional

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Payment DetailsIf you would like to pay in two installments of $1,250, submit the form without payment information and I will send you an invoice if you are accepted into the program.

My Bag

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8 Week 1 on 1 MentorshipGet direct 1 on 1 mentorship from AJ Simmons with his 8 week program
$5,000.00Edit
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4 Week 1 on 1 Mentorship Get direct 1 on 1 mentorship from AJ Simmons with his 4 week program
$2,500.00Edit
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First Name

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Great! You're Almost Finished!

Click "Submit" to Complete Your Application!

You'll immediately be charged and redirected to schedule your first session after you sign the next page!

*By completing this application, signing, and clicking submit, you agree and consent to the following terms:

*To receive calls, or texts about our products and services at the number you provided above, using an autodialer. You agree that such calls or texts may be considered telemarketing or advertising under applicable law, and that you are not required to provide your consent to these calls to make a purchase from us.

*You agree that there is a strict no refund policy on this service because it is a time-based service and the time can not be returned to the mentor.

*You agree to attend all of your scheduled appointments and that you will arrive within 10 minutes of the time scheduled. Should you miss a session, you are entitled to 1 reschedule per session. If you miss the rescheduled session, you forfeit that session.

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Your Signature

Clear