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QUESTIONNAIRE

Full Name *

Email Address *

Phone Number *

What do you currently do for work? *

On a scale of 1-10 how much do you enjoy your job? *1 - Not at all2345678910 - It's amazing!

What are your reasons for the score you just gave? *

Do you currently have a business? If so, what is it? Provide any necessary links.

What is your current yearly income from your job or business?

What income approximately would you ideally want to earn from a business? *

What are your goals for the next 12 months? *

How can Shifts to Success help you with that? *

What is the #1 thing holding you back from your goals? *

What difference would it make to you to achieve these goals? *

What will it mean to the important people around you to achieve those goals? *

What will happen if you don't achieve your goals? *

On a scale of 1 to 10, how driven of a person would you say you are? *1 - I'm lazy2345678910 - I'm extremely driven

On a scale of 1 to 10, how serious are you about building a successful business and gaining financial independence? *1 - Not so serious2345678910 - Dead serious!

Is there anything else you'd like to tell us about yourself, your business, etc that will give me a clearer picture of who you are?

Are you ready to achieve your goals? Please type your initials in this box to confirm you've answered these questions honestly, you're ready to learn, and eager to build a business.

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After you click submit, you will be invited to book a 10 min complimentary brainstorming session with a Shifts to Success Start-Up Specialist. In this brainstorming session, we will take a closer look at where you want to be in life/business.

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