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Business Name *

Website

First Name *

Last Name *

Email *

Phone *

Facebook URL *

Social Media URL *

Briefly Describe Your Business and Background: *

What's Your Current Monthly Income? *

$1K / Month (or less)

$1K - $5K / Month

$5K - $10K / Month

$10K - $20K / Month

$20K - $50K / Month

$50K / Month (or more)

Approximately how many hours per week are you in your Business? *

10 - 20

20 - 30

30 - 40

40 - 50

Over 50

What's Your Desired Monthly Income? *

What are some reasons for not achieving this income so far? *

Time

Energy

Lack of Scalability

Lack of resources to innovate, expand & scale

Lack of support

Other

If Other, what are they?

What Would It Mean To You To Reach This Income Goal? (how would your life be different?) *

Have you ever been involved in Collaborations / Joint Ventures? *

Yes

If Yes, with what product/service and was it a good experience?

What benefits to you and your business are you looking for in a "Power Team" joint venture? *

If our Business Model is aligned with your goals and you're willing to get started, when do you want to start? *

Yesterday

Now

Within a Week

In The Next Month

I'm More Curious Than Serious

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HEALTH PRO24".

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