PLEASE FILL OUT YOUR

BASIC INFORMATION

Full Name

Email *

Phone *

Basic Information *

Company Name
Job Title
LinkedIn Profile URL

Company Name *

Job Title *

LinkedIn Profile URL *

Investor/Founder - Specific Information (Are you an Investor or Founder?) *

Investor

Founder

Both

Current Company Stage (for Business Owners/Entrepreneurs) *

Pre-Launch

Early Stage (Initial Growth)

Growth Stage (Expanding Operations)

Mature (Profitable/Scaling)

Industry Focus *

Company Infomation (Mastermind Matching) *

1. Company Website
2. Yesr Founded
3. Number of Employees

What are your TOP 3 GOALS for attending this event? *

1.
2.
3

What challenges are you currently facing in your business/investing? *

Do you have any partnerships or collaborations you are seeking? *

How can we best support you during this MASTERMIND? *

Event Package & Participation

1. Which MASTERMIND PACKAGE are you purchasing?

$5,000 Package

$10,000 Package

2. Do you require hotel accomodations? *

Yes

No

Dietary Restrictions or Special Requests: *

Will you be participating in the 1:1 Coaching Sessions (for Tier 3 Participants) *

Yes

No

Networking Information

Are there any specific attendees you would like to connect with during the event? *

Are you interested in participating in a recurring mastermind? *

Preferred method of post-event follow-up *

Email

Phone

Other

Consent & Legal

Do you consent to having your NAME, COMPANY, and PROFILE shared with other participants for networking purposes? *

Yes

No

Would you like to receive future event updates?

Yes

No

Agreement to Terms and Conditions *

I agree to the terms and conditions of the event, including the privacy policy

THANK YOU!

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Site: www.empowerinvesting.net

PLEASE FILL OUT YOUR

BASIC INFORMATION

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