Preliminary Application

Thank you for your inter­est in work­ing with me. Please fill out the fol­low­ing pre­lim­i­nary appli­ca­tion form. I turn down the major­i­ty of new client inquiries when a prospec­tive client isn’t a good fit. My track record for results is very high in my “sweet spot”. The sweet spot is deter­mined by a com­bi­na­tion of the clien­t’s tar­get mar­ket, com­pa­ny life stage, and CEO skillset.
 
After sub­mit­ting your com­plet­ed appli­ca­tion, I will review it with­in a week. If there’s no fit, my staff will let you know along with any appro­pri­ate refer­rals to oth­er resources. If the fit looks promis­ing, my staff will sched­ule an inter­view for me to learn more about you and your busi­ness and for you to learn more about me to mutu­al­ly decide if work­ing togeth­er makes sense.
I am applying for:
First Name *
Last Name *
Company *
Job Title *
Email *
Annual Revenue *
Website
# of Employees: *
Business Description *
Product/ Service Description *
Target Customer *
Financial Performance of Company (Sales growth rate? Cash flow positive - yes or no?) *
Goal for Next Year *
3 Biggest Obstacles *
3 Biggest Opportunities *
What are You Hoping I can Help With? *
What Would Have to Happen within 12 months of working together for you to see this as a successful endeavor? *
Check Here IF you want to be added to the wait list in the case that no openings are available.
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