First Name* Last Name* Email Address* Telephone Company Size Self-employed Small (2-99) Medium (100-499) Large (500+) Job Title What are the top 3 challenges or issues in your business and personal life that are getting in the way of doing what you love, loving what you do, and achieving the results you want? 1 2 3 Which of the following areas of your life would you like to improve on? Environment Spirituality Business/Career/Studies Family Health/Well Being Bereavement Finance/Wealth Fun/Recreation Personal Growth Self-Image Social/Friends Love/Romance Life Transition Please check off all the areas that you need help with in your business Vision/Mission Marketing/Sales Organizational Development Financial Leadership Staffing Industry Competitiveness Strategic Planning Products/Services Management Other If you selected other, please explain and/or add any additional comments below.
