1. ➔Full Name *

3. ➔Phone *

4. ➔Email *

5. ➔Instagram (Type N/A: if not applicable) *

6. ➔Age, Current Career, Annual Income *

7. ➔What is the motivating factor of you wanting to pursue something new? *

8. ➔ Favorite Book or Podcast *

9. ➔ How did you hear about this opportunity? *

10.➔What state do you live in? *

State_You_Live_In

11. ➔On a scale of 1-10 how well do you communicate? *

🟥1-3: To be honest, I need to work on this

🟨4-7: Good but it could be better

🟩8-10: I respect and value communication