Name * First Name Last Name Email * Phone * (###) ### #### What Are Your Goals * Where Do You See Yourself in 5 Years * Experience * 0 - 3 Years 5 - 10 Years Veteran Current Income * $15k - 25K $25 - 50K $50 - 100K $100K+ What are you looking to get out of Mentorship? * Are you Teachable? * Yes No Coachable? * Yes No Do you have good WorK Ethic? * Yes No Do you consider 40 hours Full Time? * Yes No Are you going to give 100% towards your success? * Yes No Are you willing to commit? * Yes No Do you have a good attitude? * Yes No Are you ready to take massive action? * Yes No Thank you! Don’t leave for tomorrow, What you can do today!
