Name:

Phone Number:

Email:

Subject:
Pre Qualify Form

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1. Where are you right now in your leadership or entrepreneurial journey?
A. I’m just starting to grow my business or brandB. I’ve been in business 1–3 years and building momentumC. I’m established but ready for more visibility and growthD. I’m already recognized and looking to expand my impact

2. What inspired you to want to speak or share your story at this stage of your life?
A. I’m ready to inspire others with my personal journeyB. I want to position myself as an authority in my fieldC. I’m looking to grow my brand and reach new audiencesD. All of the above

3. Have you ever spoken on stage or shared your story publicly before?
A. No, this would be my first timeB. I’ve done some small local events or podcastsC. I speak occasionally but want to elevate my platformD. I’m an experienced speaker looking for larger stages

4. How strong is your current personal or business brand?
A. I’m still building my brand presenceB. I have a small but loyal followingC. My brand is growing and gaining tractionD. My brand is well-established and influential

5. What goals do you want to achieve by joining the Lead Like a Woman Experience?
A. Build confidence and visibility as a leaderB. Gain media and PR exposureC. Connect and collaborate with other high-impact womenD. All of the above

6. What best describes your readiness to invest in your brand visibility this year?
A. I’m exploring my options and preparing to invest soonB. I’m ready to make a small-to-moderate investmentC. I have a marketing budget set aside for growthD. I’m actively investing in opportunities that elevate my brand

7. What’s your current monthly revenue range from your business or career?
A. Under $5,000/monthB. $5,000–$10,000/monthC. $10,000–$25,000/monthD. $25,000+/month

8. How much are you currently investing each year in personal or professional growth (coaching, branding, events, PR, etc.)?
A. Under $2,000/yearB. $2,000–$5,000/yearC. $5,000–$10,000/yearD. $10,000+/year

9. When you see a powerful opportunity that aligns with your goals, how do you typically make investment decisions?
A. I like to think about it and plan for laterB. I discuss it with a partner or mentor before decidingC. I decide quickly when I see clear value and ROID. I’m decisive and take action when it aligns with my vision

10. What kind of exposure or recognition would excite you the most?
A. Speaking on stage and being seen as a thought leaderB. Being featured in a book or publicationC. Media and PR visibilityD. All of the above

11. What type of community are you looking to surround yourself with?
A. Women who are supportive and empoweringB. Women who are successful and drivenC. Women who challenge me to grow and level upD. All of the above

12. Which of these statements best describes your vision for 2026?
A. I want to build my confidence and grow my brandB. I want to increase visibility and expand my businessC. I want to become the go-to expert in my fieldD. I want to create legacy-level impact and be seen globally

13. What would make this opportunity a “yes” for you?
A. Seeing clear results and ROI from the experienceB. Being surrounded by other high-level womenC. Having professional media exposure includedD. All of the above

14. If selected, how soon would you be ready to schedule your onboarding call and begin the process?
A. Immediately — I’m ready nowB. Within 2 weeksC. Within the next 30 daysD. Later this quarter