First and Last Name *

Business Name / What You Do *

What is your website (or preferred social site if you don't have a website) *

For which program are you applying? *

Which meeting times work for your schedule (Jan.-April 2018). Select all that apply.

Do you have a specific goal you're hoping to crush as a result of being part of this program? (If so, what is it?). Why are you applying; what do you hope to get from the 3-month program? *

Is there anything else you want me to know? *

If selected for the program, will you commit to fully participating during the 3-month program? *

If you're selected, full payment for the mastermind, or 50% payment for the group or 1:1 programs, must be remitted (via Paypal) by January 6th, 2018.

All programs will begin the week of January 16th, 2018.

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