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WORK WITH MICHELLE
I want to get to know you a little better before we have our FIRST consult.
This form will cover you and your business or business idea. Let's get started!
First Name
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Last Name
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Company Name
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Email Address
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Phone Number (with area code)
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Address 1
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City
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State/Province
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Zip/Postal
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Best way to contact: (select one)
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Call
Email
Text
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The Business Booster Program
The Business Building Program
Private VIP Business Building Strategy Day
The Achieve Program
The Ultimate Performance Program
Inner Circle Mastermind Program
Your online presence: Website URL
Select Social Media Used:
Facebook
Instagram
Pinterest
Twitter
LinkedIn
Other
Other
Do you use email marketing?
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Yes
No
Tell me about your Business
Where in the business life cycle are you?
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Start-Up
Growth
re-Invention
Established
What is your current business or business idea?
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Identify your trading area
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Locally
Regionally
Provincially
Nationwide
Internationally
What is your personal mission in business? Why do you do what you do?
Your ideal client is a
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Man
Woman
Either
Have you completed any market research?
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Yes
No
In Progress
What marketing strategies have you developed?
What do you want out of this business? Self-employment, or build a scalable empire.. or something in between? Please be as specific as possible.
If you are NOT a start-up business, what is your average net profit?
If you are NOT a start-up business, what are your average annual sales?
Do you have a business plan?
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Yes
No
Your Team
Do you currently have employees? If "YES", how many? What positions do they fill?
Do you have a business team? Do you, or have you ever considered outsourcing accounting, marketing, administrative or any other functions? Give a description below.
Goalsetting
If you had 3 key goals for your business, what would they be? Please be specific.
What are your sales goals for the next 90 days?
What was your greatest success in business over the last year?
What issue(s) or roadblocks are you currently struggling with?
What are your objectives or expectations for our business coaching sessions or VIP Business Building Strategy Day?
Skills and Abilities
Indicate areas that you may need to learn and/or gain skill in (check all that apply).
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Writing a Business Plan
Deciding on a business structure (Sole Proprietorship, Partnership, Shares/Incorporation, etc.) Market Research and Feasibility Assessments
Financial Planning (Cash Flow Projections, Break Even Strategies, Pricing, Costing, Assessing Margins, etc.)
Branding
Marketing (Conventional & Digital) Setting Goals
Accessing Grants/Resources/Scholarships
Help with improving productivity
Market/Product/Process/Technology Development (Circle those that apply)
Effective Networking
Sales and Customer Service Prototype Development Time Management
Financial Management
Human Resources (Planning, Hiring, Management, Labour Laws)
Developing the mindset for success
Computer Skills
Go-To-Market Strategy Finding Investors
Pitch making to investors
Preparing and Understanding Contracts Export readiness
Long-term Sustainability Planning
Things to Consider
1. TIME:
Based on your current employment and personal commitments, how much time do you have per week to dedicate to working in and on your business?
2. MONEY Do you have access to sufficient funds to support yourself (and your family, if required) during the start-up season?
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Yes
No
Do you have immediate access to capital funding/gifts/financing to support you personally and/or your business during the start-up process (please indicate if this is something you need to explore in the early stages of your coaching program)?
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Yes
No
Do you have a good credit score/history?
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Yes
No
3. RELATIONSHIPS:
Have you had conversations with your family and/or the people in your support system regarding your business venture? Do they know the potential risks, rewards, time and money commitments and sacrifices involved?
Available Dates
1st Date: Please write Date and Time:
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2nd Date: Please write Date and Time:
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3rd Date: Please write Date and Time:
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After form is received, Michelle will contact you to set up your appointment and discuss payment arrangements.
I have read and understood the
terms and conditions
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Yes
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