Mentoring Program Questionnaire

Please take a few minutes to respond to the questions below. Your responses will help me get to know you and your business more fully so we can make the best use of our time together.

Please be sure to fill out all the fields. Then, click the Submit button. Wait until you see a message saying the form has been successfully submitted, before you close your browser.

Please tell me about you.
Your name:*
First Last
Today's Date*
Email Address:*
Phone number:*
Address:*
Time Zone:*
Not all of these questions will be relevant to your particular business. Please answer the ones that are pertinent to you, and write N/A under any that are not applicable.
Please tell me about your business.
Your business’s name:*
Business website URL: http://*
Social Media Links
How long have you been in business?*
How do you feel about your business? What are the central gifts and challenges it offers you?*
What is your vision for your business?*
What are the qualities and values that are essential to your business? What matters most to you?*
What is the central message you and your business are here to bring to the world?
What are your specific goals for your business, over the next 12 months?*
Who and what inspires you, and why?*
Please tell me about your clients.
Whom do you serve?*
Why do you feel called to serve them?*
What do your clients and customers need, and how do you serve their needs?*
What do you want people to experience, when they enter the world of your business?*
Please tell me about your relationship with your business.
How would you describe your relationship with your business? How do you feel about this?*
What brings you alive, in your business?*
What challenges you, in your business?*
What depletes or exhausts you, in your business?*
In what ways do you feel creatively engaged?*
In what ways do you feel creatively stagnant or blocked?*
Please tell me about your dreams and intentions.
What are your deepest desires right now?*
What would be a miracle for you, in your business, this year? In five years?*
What would be a miracle for you in your life?*
What would you like to create and/or transform during our time together?*
Please tell me about money in your business.
What are your primary revenue sources, and what percentage of your revenues derive from each?*
How do you feel about these income streams? Are there any that you wish to expand or relinquish in the year ahead?*
What was your gross revenue in the most recent fiscal year?*
What was your net revenue, before taxes, in the most recent fiscal year?*
How do you plan for and manage cash flow, in your business?*
What is your blue-sky revenue goal for your business in the next year? In the next two years?*
Please tell me about your team.
Who are the key members of your team? What are their roles? How long has each of them worked with you?*
How do you feel about each of these folks? What are the gifts and challenges they contribute?*
Are there consequential gaps in the support provided by your team? (e.g. You have a great COO, VA, book-keeper, client service person, social media manager, but need a skilled copywriter, project manager, marketing director, etc.) What essential positions need to be filled, in order to reach your revenue goals for the year ahead?*
Scheduling

Your sessions will be scheduled on the 1st, 2nd, and 3rd weeks of each month, usually between 1 and 4 pm Pacific Time, Monday through Friday.

If you’re in Australia, Europe, Africa or Asia, please let me know. Depending on my availability, we’ll schedule your sessions at a time that works for both of us.

Please list three potential days and times that you would prefer.
Preferred Date & Time #1:*
Preferred Date & Time #2:*
Preferred Date & Time #3:*
Finally…
Is there anything else you’d like to share with me, before we begin?*
Please save a copy of your responses for your own records before submitting the form online.

Thanks so much for taking the time to consider and respond to these questions. I’m looking forward to accompanying you as you unfold the miracle of your life and business.

Hiro

Please tell me about you.

Not all of these questions will be relevant to your particular business. Please answer the ones that are pertinent to you, and write N/A under any that are not applicable.

Please tell me about your business.

Please tell me about your clients.

Please tell me about your relationship with your business.

Please tell me about your dreams and intentions.

Please tell me about money in your business.

Please tell me about your team.

Scheduling

Finally…