Mastermind Application Form

Thank you for your interest in doing one of our Masterminds for Education. In order to ensure that each Mastermind has the right combination of people with complementary experience and goals, we need you to answer some questions. Some of these questions may require you to ponder the answer for a bit so don't be afraid to come back to it later.

Please tell your full name.

Email address 

Why do you want to be a part of a Mastermind?

What are your professional development goals?

What are your biggest obstacles?

What strengths, skills and experience do you bring with you that you are willing to share?

Which schedule would best fit your current obligations? It is of the utmost importance that you are able to attend consistently.  Please keep that in mind when choosing.

First choice

I would prefer to meet:

Second Choice

Please leave us a phone number and the best time to reach you at that number.

© All Rights Reserved