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1. Name and Pronouns
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(Ex. Gail Nott She/Her)
Full Name
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2. What is your race/ethnicity?
(We collect demographic information of applicants so we better understand the diversity of our audience and applicants. )
Race/Ethnicity
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3. What is your email address and website address (if applicable)?
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4. How did you find out about us? Were you referred by someone?
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5. What is the biggest challenge you face at the moment?
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Business Information
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Business Name
Owner(s) Names
Number of staff and what type (Full-time, Part-time, Contractors, etc.)
How long have you been in business?
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Do you have a...
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Mission Statement
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Written Plan
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P&L Statement
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Revenue
Year - Gross - Net - Average Number of Sales
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Competitors
Competitor 1
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Competitor 2
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Competitor 3
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Budget and Money
Marketing
Training/Personal Dev
Advertising
Current Business Debt
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Rate Your Systems 1-10
Rate your systems, 10 being the best.
Brand
Marketing
Referrals
Sales
Operations
Financials
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Describe your primary means of obtaining business:
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Top Business Goals
Goal - End Date - Progress
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Top 5 Business Concerns
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Personal Accomplishments Planned For This Year
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3 Things You Are Sick & Tired Of In Your Business
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9. On a scale of 1-5 how prepared are you to get started.
1 - Not ready. I’m looking for more information on your services.
2 - I’m somewhat ready. I know I need to work with someone and am looking at my options.
3 - I’m ready, I just need the details to make sure it’s a good fit.
4 - I am so ready. I’m familiar with Take Wing Coaching’s work/or have been referred by a trusted person.
5 - Sign me up now. I needed to hire Take Wing Coaching yesterday.
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Please verify that you are human
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