Lead Capture Form

Your Personal Name (not company)

Email Address

Contact #

What services/products are you looking for? Check all that apply:

Master Your Books Bootcamp

Content Creation

Financial & Tech Confidence Coaching (1:1)

Public Educator/Speaker

Strategic Business Partnership (provide more detail in "tell me more")

Just using contact form to connect (provide more detail in "tell me more")

Which Industry do you work in?

1099Contractor/On-Demand Freelancer

Real Estate

Retail

Restaurant

Professional Services

Construction

Wholesale Distribution

Manufacturing

Non-Profit

Do you own a company? What is it called? How long? or Not Yet.

Have you attended my training(s) and/or public speaking events? If YES, which one(s)?

Preferred day/time for meetings (include your time zone)?

Who shared the Love? Let me thank them!! (optional)

Anything else I should know? (the more, the better) (optional)

You have a website? (optional)

You on Facebook? (optional)

You on Linkedin? (optional)

You on Twitter? (optional)

You on Instagram? (optional)

You on YouTube? (optional)

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