BRILLIONAIRE WEALTH STRATEGY APPLICATION

1
What’s your full name?* This field is required.What’s your full name?
Prefix
First Name
Middle Name
Last Name
Suffix
2
What’s your best email address?* This field is required.
example@example.com
3
Phone Number * This field is required.
4
What’s the name of your business?* This field is required.
5
Which VIP Day experience are you interested in?
Brillionaire Wealth Strategy
Brillionaire Wealth Strategy (with spiritual insight)
Brillionaire Wealth Strategy + Trademark W.E.A.L.T.H Add-on
Brillionaire Wealth Strategy (with spiritual insight) + Trademark W.E.A.L.T.H Add-on
6
What type of business do you operate? * This field is required.
Professional Services (Law, Medical, Therapy, Accounting, etc.)
Faith-Based Organization or Nonprofit
Consulting
Coaching
Online Courses
Digital Products
Speaking & Media
Business Services (Branding, Marketing, etc.)
Retail
e-Commerce
Other
7
If you answered "other" above, describe your business
8
How long have you been in business?* This field is required.
Less than 1 year
1-3 years
3–5 years
5+ years
9
What’s your current average monthly revenue? (Confidential — for internal use only)* This field is required.
Under –$10K
$10K–$25K
$25K–$50K
$50K-$100,000
$100,000-$500,000
$500,000+
My revenue fluctuates, but I am actively scaling and investing
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Website Address
11
Link Your Social Media Handles
12
What are your top 3 intentions for your business and yourself in the next 60 days?* This field is required.
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What are the top 3 roadblocks you're currently facing that you perceive are holding you back from receiving that result?
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What are your top 1–3 legal priorities right now?* This field is required.
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Large
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Small
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Ok
15
Have you previously worked with an attorney for your business?
YESNO
16
If you worked with an attorney before, what was your experience like?Do not include names. However, include what service you would like to have when working with an attorney, and if your past experience(s) met your expectations.
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Large
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Ok
17
What assets do you currently want to protect, audit, or expand?* This field is required.
My brand name, logo, slogan, or product names
My digital course, membership, or coaching program
My book, audio content, or proprietary written materials
Licensing opportunities (e.g., brand collaborations, white labeling, affiliate partnerships)
Content or curriculum I want to license or protect
My speaking platform or media visibility
Business contracts or agreements that need a legal audit
Website policies or online compliance
My intellectual property portfolio (audit + strategy)
My team structure (contractors, employees, or partners)
A strategic plan to protect and scale my brand
Other
18
What is the deeper “why” behind your brand or business?
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Large
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Small
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Ok
19
What would it mean for you to receive legal clarity and support that honors both your business goals and your spiritual growth?
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Large
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Small
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Ok
20
What role does faith, purpose, or spiritual alignment play in the way you lead your business?
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Large
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Small
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Ok
21
Would you like Michelle to pray over your business or offer encouragement as part of your Brillionaire Wealth Strategy Session?
Yes, I would love that
TNo thank you, I prefer a legal-only focus
I'm open to it
22
These elite-level strategy experiences start at $5,000. Are you ready and able to invest if accepted?* This field is required.
Yes, I’m ready to invest in myself and my business
I’d need a payment plan
Not at this time. However, I am interested in scheduling a consultation call with you
Not at this time
23
Is there anything else you'd like us to know about you or your business?
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Ok
24
Signature* This field is required.Thank you for sharing your time, truth, and vision with me. By signing below, you confirm that all information provided is true to the best of your knowledge and that you understand this application does not guarantee acceptance. If selected, you’ll receive the next steps to confirm your spot for the Brillionaire® Wealth Strategy experience you’ve chosen. I understand that if selected, I will be invited to schedule a call to finalize details and move forward with the selected service.
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