Inner Circle Member Application

Today's date *

How you learned about this Inner Circle *

Your name *

First

Last

What you like to be called *

Gender

Email *

Phone number *

How you prefer to be contacted *

Where you are located and your time zone *

Your active social media forums and how to reach you

If you’ve ever authored a book, tell us about it

If you’re authoring one now, tell us about it and the stage it’s in

Business name *

Your role in the business *

Number of years at this business *

What does the business offer and to whom? *

Business website *

What is your expertise. special sauce, superpower or world-class knowledge? *

What are your business or income goals and success measures for the next 12 months? *

What are your business or income goals and success measures for the long term? *

Which topics about growing a lucrative business do you want to explore in this Inner Circle? (Choose all that apply.) *

How much do you know about income streams that can monetize your expertise? *

Do you have income streams in mind to explore via this Inner Circle?

What do you hope to accomplish during/your purpose in joining this 1-year Inner Circle? *

How will you determine/measure this Inner Circle’s success? *

What can this group help you with in the first 90 days? *

Anything else you want us to know about you or your business?

Will you make attending our events and getting to know and support other members a priority? *

What can we do to enable you to commit to this?

Will you commit to the Inner Circle Values and Rules at https://executiveauthors.com/mastermind-and-inner-circle-values-rules? *

Will you be able to pay the 2024 fee of $12,000 prior to the group’s first April 2024 meeting? *

Consent *

I consent to this website storing my submitted information so the site's staff can respond or request additional information.