Business Accelerator Group Coaching Cohort Data Form
Congratulations on making the decision to be a part of the Business Accelerator Group Coaching Cohort. Please fill out this form completely. Think long and hard about the answers. Be honest and thorough.
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Email *
First Name *
Last Name *
If either of your names have a special pronunciation, please indicate how to pronounce it here.
Today's Date *
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Date of Birth *
MM
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DD
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YYYY
What is your sex? *
Phone number *
Mailing Address *
City *
State or Province *
Country *
ZIP Code *
Please share your social media links (Facebook, Twitter, LinkedIn, Instagram, etc.): *
List 5 or 6 words that OTHERS would use to describe you. *
What would you consider your primary business expertise currently? *
What does "SUCCESS" mean to you? Define it in your own words.
Rate your self-esteem *
LOW
HIGH
What is your favorite hobby or pastime? *
What is the name of your business? *
What is your business website? *
When did your business begin? *
Rate the success of your business. *
We suck bad and I need help!
I'm achieving all my life goals because of this business.
What is the current annual revenue of your business? ($USD) *
How many employees do you have on payroll? (Do not include yourself in this number.) *
How well do you accept direction and constructive criticism? *
I don't like it
I cherish it
Who is the leader you admire most and why? (Living or dead) *
List the best three books you've ever read. *
What is your level of commitment to personal development *
LOW
HIGH
Why did you apply to this group coaching program? *
Do you currently have a personal mentor or coach? If yes, please explain the key lessons you have learned. *
Do you have a daily/morning routine? If yes, please describe it. *
I would consider myself to be __________ at implementation and follow-through. *
List three things that you feel like you need to work on. *
As part of this cohort, you need to be able to devote a MINIMUM of 2-3 hours per week to the program, attending calls and completing action items assigned by your Coach. Do you understand and accept this time commitment? *
The cohort will meet for 8 hours (2 hours each week for 4 weeks). If you miss more than 1 session, you will not be allowed to continue your participation in the cohort and you will not receive a refund. Do you understand and agree to this? *
I understand and agree that I will learn things about my fellow participants that are not allowed to be shared outside the group and likewise I will share things that I do not want to be shared outside the group. I commit to maintaining absolute confidence and will not disclose any private information to anyone outside my cohort and that if I do, I will be kicked out of the cohort and will not receive a refund. Finally, I agree to allow my contact information to be shared with other members of my cohort. *
Please write the #1 goal you have as a participant in this program... *
T-shirt size (unisex) *
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