ManifestX Mastermind Membership Form

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First and Last Name *

Why did you decide to connect with us now? *

What have been your 3 proudest accomplishments and WHY?? *

Briefly describe your business, who do you serve, what do you sell, price point? *

Current Business Website (If you don't have one please type "no site") *

Current Monthly Revenue: *

Less than $3000 per month

$3,000 - $5,000 per month

$5,000 - $10,000 per month

$10,000 - $20,000 per month

$20,000 - $50,000 per month

$50,000 - $100,000 per month

$100,000 per month or more

What is your target monthly revenue? *

What does your dream life & biz look like in 3 years from now? Be as specific as you can. Include numbers. Clarity creates reality. :) *

What do you think is your biggest bottleneck or challenge in getting there? (internal and external) *

How willing & able are you to invest in the growth of your business right now? *

If we determine this is a good fit would you want to use third party funding? (we have funding sources available)

Yes

Maybe

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If you're accepted into the Manifest X Mastermind how soon can you get started? *

ManifestX Mastermind Membership is not Guaranteed. If we both decide it's aligned to move forward together out of 100+ of applications why should we choose you to be a part of it over the next applicant? *

Are you willing to complete your PRE-Call masterclass to ensure you qualify to become a member? *

Yes

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