Fearless Impact
1:1 and Excel Group Intake Form
First, Last name
(Required)
1. What is your 6 month goal? Specifically, what monthly income would you be 'happy' with, 6 months from now?
(Required)
2. How much time per week do you have to spend on building your business? (Please be as practical as possible...better to underestimate, than overestimate)
(Required)
3. The following question is neither a guarantee or an indicator of outcome, it's simply to identify available resources. If you knew for sure, you'd reach your 6 month goal, how much could you afford to invest monthly for the next 6 months if NO revenue came in?
(Required)
4. As it relates to this business, do you have the support of anyone (spouse, family, friends, etc). Explain:
(Required)
5. What are the types of business activities/hobbies you enjoy (writing, speaking, designing, etc)
(Required)
6. Are there any business activities you know for sure you do NOT want/like to do?
(Required)
7. List any specific challenges or issues that you're currently facing that impact your ability to hit your goals? (technical, time, know how, systems, etc)
(Required)
8. What skills/talents/knowledge do you feel can contribute to your success?
(Required)
9. What areas do you feel you need the most help from our coaching?
10. What brings you joy? (list any an everything you can think of)
Personality
Please visit this site and complete the free assessment at
16personalities.com
Then enter your information below:
Enter your personality type from the site above
(Required)
Please rate yourself from 1 - 10 (10 being the highest) in your familiarity/skills with the following:
1. Social Media - General social media familiarity
1
2
3
4
5
6
7
8
9
10
2. Social Media - Social media marketing
1
2
3
4
5
6
7
8
9
10
3. Affiliate marketing
1
2
3
4
5
6
7
8
9
10
4. Paid Ads - Google AdWords
1
2
3
4
5
6
7
8
9
10
5. Paid Ads - Bing
1
2
3
4
5
6
7
8
9
10
6. Paid Ads - Faceboook
1
2
3
4
5
6
7
8
9
10
7. Paid Ads - LinkedIn
1
2
3
4
5
6
7
8
9
10
8. SEO
1
2
3
4
5
6
7
8
9
10
9. Autoresponders
1
2
3
4
5
6
7
8
9
10
10. Shopping Carts (Infusionsoft, Zaxaa, 1Shopping Cart, Shopify, etc)
1
2
3
4
5
6
7
8
9
10
11. Content marketing
1
2
3
4
5
6
7
8
9
10
12. Writing (Articles/ Blogging)
1
2
3
4
5
6
7
8
9
10
13. WordPress
1
2
3
4
5
6
7
8
9
10
14. Sales
1
2
3
4
5
6
7
8
9
10
Is there anything else you'd like to share with us that can make your experience GREAT?
© 2023 by Fearless Impact