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Name
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Email
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Phone Number
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Business Name
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Describe your business: Who do you help & what are the primary benefits you deliver for your clients and customers?
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Your Business URLs: Feel free to include blogs, Facebook Fan pages, YouTube Channels and product pages (if you have them):
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Your total annual income:
Percentage of your total income you make from the business we will be working on:
What is your income goal?
The 3 most important goals that would make the biggest difference in your business over the next 180 days.
Why would you be an amazing addition to this group?
On a scale of 1-10 how committed are you to making your business a success in the next 180 days?
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