The Mastermind Application

Thanks for your interest in The Mastermind. Please fill out this form. Then we can schedule a quick call so we can get to know each other and I can answer any questions you might have.

Name *

First

Last

Email *

Phone Number *

Snail Mail Address *

Address Line 1

Address Line 2

City

State

Zip Code

What do you do currently for work? *

Your Website / URL (if applicable)

What’s the main area of your life that you’d like to change, reinvent, or relaunch right now? *

For example: "I have been a stay-at-home parent for the last two years. I want to re-enter the workforce and relaunch my career!"; OR "I have had a successful career (or many of them). I am ready for a change."; OR "I have been feeling blah and lethargic for awhile. I want to change my daily routine, get more energy, and start to feel more clear about where my life is heading.", OR "I am going through a divorce. I want to relaunch my whole life! For starters, I would like to focus on my financial wellbeing and re-energizing my business."

Choose the description that best fits your current situation. *

I know what I love to do, but I need guidance and support on how to create processes and procedures that support where I am and where I want to go.
I need support and resources to grow my business/career or further the cause or pursuits that I'm passionate about. I need accountability and ideas to increase results.
Other

If “other” please list any other descriptions that best fit your situation above.

What do you hope your life and career will look like one year from today? *

What would your close friends say are your best qualities? *

(Example: "patience," "compassion," "confidence," "awesome sense of humor," etc.)

What are you most proud of in your life? *

How much time can you commit each month outside of meetings? *

The value you get from participating in the mastermind group depends on your commitment to do the work between meetings and to show up fully. For maximum benefit, please expect to spend 2-3 hours/week (8-12 hours/month), in addition to online meetings, on assignments, contributing to the message board, and working on meeting preparation and reflection.

What do you hope to gain by being part of a mastermind group? *

PAYMENT: Registration for this program is $4,500. This price includes 12 online mastermind meetings, two 1-1 private coaching sessions, inspiring and exciting guest teachers and interviews, generous support from a professional career and life strategist, an accountability partner, and a group of like-minded people who share the same goal of reinventing their lives and careers, and a refreshing weekend retreat. You can pay online with any debit/credit card. Please indicate your desired payment plan: *

1 Payment of $4,500
4 Payments of $1,125
Something else *please note, not all requests for alternative payment plans can be accommodated, but I am happy to discuss*

If "something else" please describe your payment preference above

CANCELLATION / REFUND POLICY: Life isn’t always perfectly smooth. Sometimes, things arise and plans need to change. * If you enroll in Relaunch Mastermind but then you can’t attend the program (or you need to drop out early) because you’re dealing with a serious illness/medical crisis, please contact me. I can send you a refund, or switch you into another Relaunch Mastermind program that’s happening later, or we can work out some other arrangement for you. Please get well soon. * However, if you enroll in Relaunch Mastermind but then you cancel, drop out, or choose not to show up for a non-medical reason (for example: “I changed my mind,” “I forgot that I have a schedule conflict, “I didn’t find a pet sitter in time,” “I got stuck in traffic,” “I just don’t feel like it,” etc.)… you will not receive a refund. This is a non-negotiable policy. Please plan with intention. Thanks for understanding! *

Yes, I understand!

Is there anything else you'd like to share about yourself? Or questions you’d like to ask?

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