Business Mentorship Program Qualification Form

Full Name *

Email *

Phone *

Business Name (If Applicable)

Business Readiness:

1. Do you currently have an active business or plan to start one in the next 6 months? *

Yes

2. Have you already established business credit? *

Yes

Not sure

3. What industry is your business in, or what type of business do you want to start?

4. Do you have a clear business idea or plan? *

Yes

Still working on it

4. Is your business registered? *

Yes

6. Do you have the following for your business? (Check all that apply)

IN Number

DUNS Number

Business Bank Account

Business Address

Business Phone Number

Business Email Address

Business Listed on Google

Business Listed on 411

Business Logo

Business Website

Business Social Media Business plan

7. If you have a business, what are your social media handles? *

Financial Readiness:

8. Do you currently have any form of business funding? *

Yes

In Progress

9. Are you open to securing business funding and building business credit? *

Yes

10. What is your current personal credit situation ? *

Excellent

Good

Fair

Poor

Not sure

Mentorship Goals:

11. What are your primary goals for joining the mentorship program? (Check all that apply) *

Build business credit

Secure funding for my business

Start or scale a credit repair business

Get help starting and setting up a business

General business growth and strategy

Other:

12. What challenges are you currently facing in growing your business? *

Commitment and Expectations:

13. Are you willing to invest time and effort into growing your business through this mentorship program? *

Yes

14. How much are you willing to invest in business mentorship or coaching? *

$500 - $1000

$1000 - $3000

$3000+

Additional Information:

15. Is there anything else you'd like to share with us about your business or mentorship goals?

Next Steps:

Once you complete this form, we’ll review your responses and determine if you qualify for the Business Mentorship Program. If you meet the criteria, you will be contacted to schedule a consultation.