Become an Actor Application Form

Have you taken my Diagnostic Quiz? Have you taken my Diagnostic Quiz? YES (if yes, please proceed with this application) No (If no, please use the link below to take my free quiz)

What is your top diagnostic result? What is your top diagnostic result?Broke In TimeBroke In EnergyBroke In ConfidenceBroke In Follow-ThroughBroke In VisionBroke in Money/Value

Full Name

Email

City/Time Zone

LinkedIn/Website

Which of the following best describes where you are right now? (select all that apply) Which of the following best describes where you are right now? (select all that apply) I feel stretched thin and overwhelmed I know what I want but struggle to follow through I have ideas but need clarity on what to focus on I’m ready to take action but need structure and accountability I’m navigating a transition and want to move forward intentionally

What Do You Want to Work On? What Do You Want to Work On? The Become an ACTOR Mastermind helps participants build a clear personal action plan. What goal or area of your life would you most like to focus on during the mastermind?

What Do You Want to Work On? (ex. Launching or growing a business, career transition, personal project or idea, financial goals, life restructuring or priorities)

What has made it difficult to move forward on this goal so far?

Which of these challenges do you experience most often? Which of these challenges do you experience most often? Overthinking or second-guessing Lack of structure or clear plan Too many responsibilities Fear of making the wrong move Procrastination or delay Difficulty staying consistent

Have you participated in a mastermind (in-person or virtual) before? Have you participated in a mastermind (in-person or virtual) before? Yes No

This mastermind includes a small cohort of 8–10 women working toward their goals together. Are you comfortable participating in a small group environment where ideas and progress are shared? This mastermind includes a small cohort of 8–10 women working toward their goals together. Are you comfortable participating in a small group environment where ideas and progress are shared? Yes No

Why do you feel this mastermind is the right next step for you right now?

Upon completion, what would make this mastermind feel like a success for you?

Is there anything else you’d like me to know about your situation or goals?

How ready do you feel to implement and take action right now? How ready do you feel to implement and take action right now? I'm ready I'm ready, but I have a few more questions