Step 1 of 2

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• 1. Full Name:*
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• 2. Best Shipping Address*
  Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country
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• 3. Best Gmail Email*
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• 4. Birthday*
  Date Format: MM slash DD slash YYYY
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• 5. What’s your favorite book?*
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• 6. What’s your favorite place you’ve visited?*
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• 7. What’s your favorite movie of all time?*
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• 8. Who’s your favorite musician?*
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• 9. What do you believe is your super power?*
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• 10. Why did you say “Yes” to allowing us to support you?*
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• 11. What are your Top 3 biggest problems you are trying to solve in your business? Please be as specifc as possible.*
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• 12. What are the Top 3 things you want to let go of in our time together? Please be as specifc as possible.*
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• 13. What are the TOP 3 Things you want to create & implement in our time together?*

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• 14. What fears, thoughts, resistance or doubts are coming up for you on taking action on this plan or moving forward with this vision. Share everything and anything.*
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• 15. What EXCITES you The Most about this new expansion of your business? Share everything, little or HUGE.*
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• 16. Describe what you do and how you help transform people's live in as much concise detail as possible. *Choose the #1 Subject Matter you Want to focus on during our time together!**
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• 17. Who is your absolute ideal client? What are their pain points? What do you think their biggest fears are?*
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• 18. What have your clients told you about why they have hired you? Be as specific as possible please.*
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• 19. Please share any Marketing & Program Links you have right now with LINKS! (Website, Programs/products/Services page, FB Page, Webinar, Leadpages, Landing Pages, Funnels, FB Ads)**
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• 20. What tools do you have? List all that you have (auto-responder, domain name, hosting, go-to-webinar, leadpages, click funnels, website theme, etc.)**
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• 21. Please share anything else you’re want clarity on or are thinking about you want me to know about right now. **
  (What you want to expand into, what else is coming up for you that you want to do that isn’t on this form.)

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*If you have any problems submitting this form, please email kristina@kristinamarie.com and a team member will follow-up with you!*