Application: Mid-Life Entrepreneur Punta Cana Mastermind

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Thanks for your interest in attending this event! Please fill out the following information so that your application can be reviewed by our team to determine the best mix of individuals to invite to an exciting and highly valuable experience. This mastermind will be held at a luxury mansion in beautiful Punta Cana Dominican Republic and will include a private chef, bucket list activities and deep and powerful masterminding for those attempting to break free of the 9-5 but feel tethered to an income, identity or are fearful of taking the leap.

An amazing book was written that talks about how it takes 20 hours on task to learn any skill - but most of us take a long time to put that first hour in. This mastermind will force you to be immersed for that 20 hours over the course of 3-4 days which will accelerate you toward your goal much faster than you've been able to date.

First and Last Name *

Email Address *

Phone Number *

How old are you? *

What is your current W2 occupation? (write NA if not employed) *

What is your annual W2 income? *

<$50,000

$51,000-$100,000

$101,000-$150,000

$151,000-$200,000

Over $200,000

What is your current net worth? (Value of assets like real estate, crypto, stock, 401k, cash, vehicles, etc - minus - any debts like mortgages, credit cards, car loans, etc) *

<$500,000

$501,000-$750,000

$751,000-$1,000,000

$1,000,001-$5,000,000

$5,000,001-$10,000,001

Over $10,000,000

What is your marital status? *

Married

Divorced

Long term committed relationship

Single

What is your gender? *

Male

Female

I'd rather not disclose

Do you currently own any businesses, investment real estate or other assets that you are building to exit your day job? *

I have no idea what I'd do if I exited my job - I need to find my way

I have an idea of what I want to do but haven't taken action to date

I own a business(es)

I own investment real estate

I own businesses and investment real estate

What is the number one thing preventing you from leaving your day job? Share as much as you can here *

Do you have an exit date in mind? Please share any thoughts you have on this. (Don't overthink it - even if you have no plan or sense of how you'd exit, if a date is calling you, then write it down. If no date, say why) *

What do you hope to gain from attending this mastermind event? *

Do you prefer to have your own room or share? (Tuition to attend will differ if sharing vs. own room) *

I want my own room

I'd prefer to share

I'd prefer my own room but am open to sharing

I'm open to sharing with a friend that I'm bringing

Would you like to bring your spouse/significant other? (for single room only - shared rooms are for two independent attendees) *

My spouse and I would absolutely like to attend together

My spouse won't be coming

Maybe - I'll have to check with him/her

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