2015 Mastermind Application Creating Consistent Revenue Mastermind Confidential Application I am thrilled that you are adding your name to the list of determined and enterprising potential candidates to be a part of the Advance U community! It is understood that you are only showing interest in our programs and are under no financial obligation to be a part of any group Please fill this application out completely (return by email or fax) and a member of my team will be contacting you soon to arrange a private interview with me. * = Required field Today's Date * First Name * Last Name * Email * Address * Address line 2> City/State/Zip * Phone Number * Select Your Availability for Training Calls Monday MorningAfternoonEvening Tuesday MorningAfternoonEvening Wednesday MorningAfternoonEvening Thursday MorningAfternoonEvening Friday MorningAfternoonEvening 1.What do you see as the major challenges holding you and your business back from growing at the pace you want? * 2. On a scale of 0-10, how important is it for you to overcome your challenges and achieve your goals today? * 12345678910 3. If you are accepted into the program, what are the top 3 money, marketing and growth goals you want to accomplish over the next 90 days? * 4. Please describe your business or life as it is right now (including how long you’ve been in business, your revenue streams, team size, list size and successes). There is no right or wrong...Let’s just see how you view your current situation. * 5. What have been your three biggest accomplishments over the past two years? * 6. Who or what do you think is responsible for your current results? * 7. If you are accepted into the program, what are the top 3 goals you want to accomplish over the next 90 days? * 8. What would be the impact in your relationships with your family and others if you achieve these goals? * 9. Who or what do you think is your biggest obstacle in reaching your current goals for this year? * 10. What motivates you? * Please rate on a scale of 1 to 10 (10 being the highest) your satisfaction level in the following areas of your life. Please select Business 12345678910 Financial 12345678910 Family 12345678910 Health/Fitness 12345678910 Spiritual 12345678910 Recreation/Fun 12345678910 Social 12345678910 Personal Time 12345678910 Mindset 12345678910 Check off the areas you’d most like to work on… Professional Development Professional Growth and Development Business Development Leadership and Delegation Other Is there anything else you’d like me to know in considering your application? Have you ever been in a mastermind or accountability group? If yes, with whom? * How did you find out about this program? * Signature Form * Must be signed in order to be considered for Group Endeavors Creating Consistent Revenue Mastermind By signing this I acknowledge that I have read the ADVANCE U coaching Program description and would like to be considered to participate in the 2015 program. At this point in time, I understand I am only showing interest in this program and am under no obligation to be a part of this group. I further understand that if I’m accepted into this program, after submitting a payment form and contract (supplied upon acceptance), I am committed to the program for its duration. I agree, at that time, to show up fully and powerfully in my participation. Because of the exclusive and customized nature of coaching, training and live events, there are no refunds. Signature: