Mentoring Immersion Application Name* First Last Your business name*Phone number:*Address:*Your Email Address:* Business website URL: https://*Please tell me about your business. How long have you been in business? Whom do you serve, and how?*What do you love about your business?*What are the biggest challenges you face in your business?*What brings you to me at this time? What would you like to accomplish by working with me?*Is there anything else you’d like me to know about you?*Finally, how did you connect with me? If you have taken a class or program with me, or had a single strategy session with me, please let me know that too.*Which mentoring program are you interested in?*Six-Month Mentoring PartnershipTwelve-Month Mentoring PartnershipWhen would you like to begin your program?*Now or as soon as an opening becomes availableIn the next three monthsPlease save a copy of your responses for your own records before submitting the form online.