Exit this survey Question Title * 1. Contact Info: Name: * Company: Address: * Address 2: City/Town: * State: * -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: * Country: Email Address: * Phone Number: * Question Title * 2. How would you identify yourself in this business? Solopreneur (Consultant, Lawyer, Doctor, Coach, Service Provider) Entrepreneur (Company you founded) Executive (Company you joined, did not start) Manager/Director Employee Home Maker In between careers Question Title * 3. Number of contractors and employees on your team? Question Title * 4. What is your customer base/user base/subscriber list? (whichever applies) Question Title * 5. Brief Bio Question Title * 6. Briefly describe your current business: What stage is it in? Size? Industry/Niche Served? Question Title * 7. What products and/or services do you provide? Question Title * 8. What is was your income and your company's revenue in 2013? How about 2014? Question Title * 9. What are your business goals this year and next year? What are your income and revenue goals? What are your marketing and sales goals? What are your leadership and team goals? Question Title * 10. Please describe your professional life as it is right now. What's working? What's not working? Question Title * 11. Please describe your personal life as it is now. What's working? What's not working? Question Title * 12. What are you passionate about brining into the world? What is your life's purpose? Question Title * 13. Who are your top mentors, teachers and role models (if any)? Question Title * 14. What social, environmental or humanitarian causes are you passionate about? How do you want to make a difference in the world other than your immediate business? Question Title * 15. You've just finished the program. Describe your perfect outcome as if everything you dreamed of has already happened. What does your life, income and business look like? Be specific in terms of business, revenue growth, lifestyle, mindset and relationships. Question Title * 16. What are your professional and personal goals for the coming year? Be specific. Question Title * 17. What is your greatest challenges? Question Title * 18. If you could improve your ability to relate with, connect to and interact with people in a way that you cannot now, what would that be? Question Title * 19. What skills , experience, knowledge or resources will you 'bring to the table to support the growth of this group? Be specific. Question Title * 20. What skills, experience, knowledge or resources are you hoping to gain from this group? Be specific. Done