The Self-Aware Entrepreneur Enquire Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for your interest in working with me.

All information provided will be treated with the highest level of confidentiality and in accordance with current laws, as outlined in our Privacy Policy.

Email *

Full Name
*

Date and Time of Birth
*

YYYY

Time

Place of Birth
*

City, County (if applicable) and Country.

Your Current Location
*

For timezone compatibility

Company Name
*

Company Website
*

Your Role
*

(CEO, Founder, etc.)

What prompted you to seek consulting at this time? *

Briefly describe what’s happening in your leadership or business that led you here.

What are the top 1-2 challenges you're facing right now? *

(Examples: leadership struggles, decision-making, work-life balance, scaling your business, team issues, etc.)

How would you like to approach our consulting work? *

I have a specific challenge I want to tackle right away, with a focused and intensive medium-term approach.

I’m looking for a more comprehensive approach that explores my leadership, habits, and mindset over time.

I’m not sure yet and would like to discuss options.

Does your company allocate funds aimed at supporting the CEO's leadership, decision-making and personal development? *

Yes

Could you share the approximate annual budget allocated for this purpose? *

Please include currency

Would you be open to exploring alternative compensation models, such as revenue sharing agreements? *

Yes, I would consider alternative compensation models.

No, I prefer traditional fee-based arrangements.

Anything else you'd like to share about you or your current situation?

Are you available for a 20-minute call? *

Yes, I’m available within the next 7 days.

Yes, but I need to schedule for later.

No, I’d prefer email communication first.

Consent
*

I agree to be contacted via email regarding my inquiry and any relevant services, with the option to withdraw at any time.

Untitled title

DATA CONTROLLER: VYOMA

PURPOSE: To process the request made by the individual, and if consent is provided for marketing communications, to send relevant updates and promotional information.

LEGAL BASIS: Consent of the individual.

RECIPIENTS: Data may be shared in accordance with legal obligations or judicial orders, as well as with VYOMA, Google LLC, a company based in the United States, and MailerLite, a company located in the EU.

RIGHTS: Access, rectification, erasure, opposition, restriction, portability, and withdrawal of consent. If you believe the processing of your data does not comply with the law, you may contact the Supervisory Authority (www.aepd.es).

ADDITIONAL INFORMATION: Privacy policy.

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of VYOMA.

Does this form look suspicious? Report

Forms