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 *
# 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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