* 1. Name

* 2. What is the best Phone Number to reach you at?

* 3. Email Address

* 4. Facebook URL (if applicable)

* 5. What's your WHY? What are the top reasons for wanting to start a new business and be mentored by me?

* 6. How many hours a week can you devout to your business weekly with my help?

* 7. Where do you want to be in 1 to 3 years from now?

* 8. Providing we are good fit for each other, do you readily have $695-995 available to start a business?

* 9. Are you already with a company? If so, why do you have a desire to change companies?