LI Business Coaching Pre Qualification Form Pre Qualification Form What area of business do you need the most help with? Question Title * 1. What area of business do you need the most help with? Start-up Basics Money Marketing I don't have a business yet Something else not listed here All of the above OK What is your business? Question Title * 2. What is your business? OK In your own words where are you at with your business? Why do you need coaching? Question Title * 3. In your own words where are you at with your business? Why do you need coaching? OK What is your Full Name? Question Title * 4. What is your Full Name? OK What is your email address? Question Title * 5. What is your email address? OK What is your phone number? Question Title * 6. What is your phone number? OK What is your physical address (including city, state, zip)? Question Title * 7. What is your physical address (including city, state, zip)? OK What amount can you invest in your business today to be successful? Question Title * 8. What amount can you invest in your business today to be successful? $0 I'm broke! $500 I'm just get started $1000 I'm past basics but need a little help $3000 I'm serious and ready to take charge of my life and business OK What is the best date/time to reach you? You understand that we are EXTREMELY busy and will make 1 attempt to reach you at the date and time you state below. Question Title * 9. What is the best date/time to reach you? You understand that we are EXTREMELY busy and will make 1 attempt to reach you at the date and time you state below. OK Preferred contact method Question Title * 10. Preferred contact method Phone Call Email OK IM READY!