Joe Vitale’s Executive Mentoring Program Application

First Name:
Last Name:
E-mail Address:
Daytime phone:
Nighttime phone:
Country:

INSTRUCTION: Please put an X next to your answer for each question. (e.g.  _X_ Definately!)

1. Would it be beneficial to have someone like Joe Vitale, who has helped scores of others become millionaires, taking you step by step, through the same powerful strategies, to help you create wealth?

___ Definitely!
___ Not sure.
___ No!

2. Are you the type of person who is not afraid of a 
challenge and will do the things necessary to accomplish your goals?

___ Definitely!
___ Not sure.
___ No!

3. Can you commit a minimum of 10 hours per week to invest in yourself and learning your business?

___ Definitely!
___ Not sure.
___ No!

4. Will you do the necessary assigned work that will help you create a successful business?

___ Definitely!
___ Not sure.
___ No!

5. Can we use your success story to inspire others after you have achieved the success you were looking for?

___ Definitely!
___ Not sure.
___ No!

6. In order to achieve success, are you willing to take calculated risks?

___ Definitely!
___ Not sure.
___ No!

7. What describes BEST, your current situation?

___ Just getting started - I need business ideas and a market.
___ I have a good idea, but know way to market.
___ I have a business but I’m not making enough money.
___ I need a few good tweaks in the area of marketing.

8. What amount of money have you currently put aside for your business?

___ $1-$2500
___ $2500-$5000
___ $5000-$10,000
___ $10,000+

9. As briefly as possible, explain why I should select you to become part of my "Executive Mentoring Program".

ANSWER:



10. WHAT’S GOING TO CHANGE? Using the space below, tell me what will happen to you if I agree to help you.

	* Do you have financial goals?
	* What personal goals could you achieve?
	* Do you have dreams of a new home or exotic vacations?
	* Who would you help?

ANSWER:




11. What time is best to contact you on the telephone?

___ Daytime
___ Evening