Confidential Application

Completing this application is the first important step toward your acceptance into the Inner Circle.
Thorough and carefully considered answers will possess a greater weight in the evaluation process.
The application process will be swift. After receiving the completed application, we will let you know
whether you qualify for the next step – a 30-minute telephone interview.

Applicant Contact Information

Full Name

Birth Date

Company Name

Business Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Business Phone

Fax

Cell

Home Phone (for emergency use only)

Name of Assistant or Key Administrative Staff

Phone

Who (if anyone) referred you to us?

YOUR BUSINESS

What success/es that you’ve created in your business are you most proud of?

What compelled you to start the business/es you are currently running?

What companies do you have ownership of or a role in? (please list the web address for each)

What role(s) do you play in the companies/organizations you are involved with?

What dangers or risks to your current business do you perceive, that must be mitigated?

What opportunities exist that you must capitalize on?

YOU

What are three words that you would use to describe yourself?

What entrepreneurial characteristics do you possess?

What values, principles and beliefs guide your decision making on a daily basis?

What work activities suck the energy right out of you?

What isn’t happening fast enough for you to feel happy with your success?

What strengths do you have that should be maximized?

What limiting beliefs are holding you back from a higher level of success and contribution?

What is missing in your life and business that Inner Circle Entrepreneur could help you obtain?

What challenges are you facing that Inner Circle Entrepreneur could help you overcome?

What process do you have in place to recover from personal setbacks?

What are you doing on an ongoing basis to generate more personal energy and rejuvenate yourself to keep up with your hectic pace?

How do you pick yourself up when your “mojo” has gone south?

How do you best contribute to the world?

FUTURE BUSINESS GROWTH AND PROSPERITY PLANS

What are you doing to position your company/ies to win in a cluttered market place?

How do you evaluate the return on investment for every activity you do?

What systems do you have in place to deal with the setbacks that sneak up on you in business?

When it comes to managing risk, what methods and philosophies guide you to maximize return and minimize loss?

Describe the culture of your organization currently and contrast that to your ideal vision.

What methods and systems are used to ensure accountability toward goals across all facets of your business?

Please rate yourself on the following using a scale of 1 to 10 (10 being the highest and 1 being the lowest):

Measuring what you manage and managing what you measure

Making decisions in a timely manner

Managing and forecasting cash flow

Growing and developing your executive team

Integrating new ideas and change from top to bottom in your organization/s

Building an individuals’ ownership of the process and outcomes

Assessing and hiring talent

Dealing with uncertainties and unknowns

Attracting the right clients for your business/es

Spending the majority of your time on the most productive, profitable, and passionate activities

Generating the revenues and profit you want

Creating and maintaining a desirable culture in your business/es

Maintaining a healthy balance between life and work

Articulating and communicating the future vision of your company/ies

Effectively managing risk to maximize rewards and return

Interpreting the value you offer to clients to receive premium pricing over competitors

What are three of your biggest achievements so far in life and/or business?

If we were to step into your ideal world three years from today and look back in time, what would have happened in your life and business that will cause you to feel thrilled with your progress, success and significance?

YOUR COMMITMENTS AND DECLARATIONS

What kind of learning and contribution will you bring to your fellow entrepreneurs during live and virtual interactions?

What are you currently doing to make your community or the world better?

Why should ICE accept you into this program?

Product Name

Price:

Upon submission, we will be in touch with you regarding payment method

Enrollment

Once you are accepted into ICE, you will complete an Enrollment Agreement specifying terms of you membership.

Privacy Policy: Protecting your personal information
This Privacy Notice and Inner Circle Entrepreneur’s Privacy Policy, available at dynamicdirections-d2.com/ice/ice-privacy-policy/, describe Inner Circle Entre-preneur’s privacy practices in relation to the Program.

Inner Circle Entrepreneur collects personal information in the Confidential Application. By providing Personal Information to Inner Circle Entrepre-neur, you consent to Inner Circle Entrepreneur using the information for the purposes specified in our Privacy Policy. Inner Circle Entrepreneur does not rent, sell or otherwise disclose Personal Information about its clients to third parties. Inner Circle Entrepreneur may allow authorized third party service providers access to Personal Information to perform services on its behalf. These service providers are required to provide appropriate pri-vacy protection for the Personal Information, comparable to that of Inner Circle Entrepreneur, and to limit their use of such information to providing services on behalf of Inner Circle Entrepreneur. Inner Circle Entrepreneur will use its best efforts to protect your personal information against loss and unauthorized use. Our sessions may also be monitored and recorded for quality assurance and training purposes. These recordings are voluntary, and you are not required to participate in them.

If any part of these Terms is declared invalid or unenforceable by a court of competent jurisdiction, the balance of these Terms shall remain valid.

CAPTCHA

Name

This field is for validation purposes and should be left unchanged.