First Name
Last Name
Email
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Phone
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What is your stage of business?
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Idea/Concept
Pre-Revenue
Post- Revenue
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Name of Business
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Business Website
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What is the biggest challenge you are facing in your business right now?
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What is your current monthly revenue?
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What was your revenue last year?
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What is your projected revenue for the current year?
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Why do you want to join the EntreMD Business School? Please be thorough in your answer.
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Where do you see yourself in the next 3-5 years?
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Have you worked with a business coach or enrolled in a business program before?
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Yes
No
How was your experience?
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Positive
Negative
Neutral
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Why?
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In the past year, how much have you invested in your personal development?
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What is your long-term vision for your company?
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On a scale of 1-5, how committed are you to joining the EntreMD Business School?
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5
4
3
2
1
The investment is one payment of $30,000 or three payments of $10,500 for one year. Are you prepared to make this investment in yourself and your business?
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Yes
No
How do you intend to make this investment? (W-2 Income, Savings, Business Income, Other)
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Where or from whom did you specifically hear about the EntreMD Business School?
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Submission of this form is neither formal acceptance into the EntreMD Business School, nor an obligation to join. Once your application has been reviewed by a member of our team, we will be in touch with next steps.
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I Agree
SUBMIT MY APPLICATION