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First Name *

Last Name *

What State Do You Currently Live in?

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What do you currently do for work? *

Do you have any experience in sales, leadership, athletics, military, coaching, or entrepreneurship? If so, give a 1-2 sentence summary. *

If you were to explore a new venture, what are the top 3 things you’d want it to provide? (Select 3)

A — Higher Income Potential

B — Personal & Professional Growth

C — Part of Winning Team / Culture

D — Help People With Your Work

E — Remote Work / Control Schedule

F — Own a Business

What is your current monthly income? (This gives me the clarity I need to understand the gap between your current level and the income target you’re aiming for.) *

This venture requires a minimum commitment of at least 10 hours per week. Looking at your work, family, and personal responsibilities, do you realistically see yourself being able to commit at that level consistently?

Yes

No

Are you able to pass a federal background check? *

Yes

No

Getting licensed is a state requirement. The initial licensing course is $199, and depending on your state, additional costs typically range between $100 and $300. If this venture aligns with your goals, are you willing and able to make that investment? *

Yes

No

If we moved forward, what would your timeline look like for getting started? *

A — Immediately

B — Within 3 days

C — Within 7 days

D — I’m only exploring and not ready to take action yet

What is the main reason you are considering making a change right now instead of later? *

What is one trait or experience you have that would make you a strong fit for a high accountability, performance driven environment? *

What level of additional monthly income are you aiming to create once fully trained and operating at a high level? *

A — $3K to $5K

B — $5K to $8K