* 1. What is your name?

* 2. At what email address would you like to be contacted?

* 3. At what phone number would you like to be contacted?

* 4. What is your Facebook URL?

* 5. What is your current business name and what products/services does it provide?

* 6. What do you feel is your biggest challenge in your business?  What do you want Emily's help with?

* 7. Do you wish to learn how you can grow your business online?

* 8. Are you willing to invest in your education and/or tools that will help you further your business?  Why or why not?