Emerald Application

Congratulations on stepping up to claim
more joy, more passion, and more profits in your business!

Download the application for the Doing What Matters™ – Emerald Mentoring Program by clicking on the link below:

Doing What Matters™ – Emerald Invitation Letter and Application Form

I look forward to reviewing your application and to speaking with you soon!

Doing What Matters™ – Emerald Mentoring Program

Application Form

Please be honest and authentic with your answers!







Office Phone

Cell Phone




How long you have been in business?

If applicable, please describe your current business, including your revenue streams, team size, and list size.

What are the top 3 business goals you want to accomplish by the end of our time together?

What is your financial goal for 2015?

Please list your approximate gross business revenue for each of the indicated years. (Please note that this is completely confidential.)

What was your 2014 income?

What was your 2013 income?

What was your 2012 income?

Select the single best answer to the following question. When you make a decision, do you

What currently holds you back from achieving the level of financial and personally fulfilling success you want in your business?

Is there anything you think you have to give up to create amazing success in your life and business vision?

Do you have any other commitments that you feel could keep you from being successful in this program? This could be a job, community service, board commitments, family, etc.On a scale of 1-10, please rate the following question (1 being “not at all”, 5 being “somewhat” and 10 being “totally!”):

How willing and committed are you to this program, doing whatever it takes, being in integrity with your commitments and with me as your trainer and mentor?

What are the 3 biggest challenges you’re facing in your business right now (please list them in order, #1 being the MOST pressing issue)?

What does your typical workday look like?

What do you consider to be the unique message that you send to your clients?

What about you tends to most get in your way of creating bigger success?

If you could wave a magic wand and change 3 things about your business (or your life) what would those 3 things be?

What is the average monthly cost to run your business?

Are you carrying business debt?
If so, does it feel manageable to you?

Are you carrying personal debt?
If so, does it feel manageable to you?

What new or expanded products/services do you plan on introducing over the next 12 months?

What are the top 5 highest priority projects in your business right now?

What do you love MOST about your work?

What do you like LEAST about your work?

What do you consider to be your 3 strongest personal characteristics?

What do you consider to be your 3 biggest areas for improvement?

Please rate on a scale of 1 to 10 (1 being ‘not satisfied’, 5 being ‘satisfied’, and 10 being ‘very satisfied’) your satisfaction level in the following areas of your life.

a. Business

b. Financial

c. Family

d. Health/fitness

e. Spiritual

f. Recreation/Fun

g. Cultural

h. Social

i. Personal Time

j. Mental Attitude

Why is it important for you to succeed with this program? What is at stake for you?

Is there anything else you’d like me to know in considering your application?