JOIN THE
GENIUS NETWORK MASTERMIND

Remember your organization must bring in a minimum of one million dollars per year in revenue or your personal net income must be at least $300,000 per year. Investing $25,000 for the development and improvement of yourself and your organization should not be a burden for you.

You must understand and follow the philosophy that "all money earned ethically is a byproduct of value creation" and understand the value of powerful discussions, elegant ideas and a mastermind group. No big egos or battery drainers - just real players with money.

First Name:
Last Name:
Primary Email:
Phone:
Company:
Street Address:
City:
State:
Zip / Postal Code:
How Did You Hear About The Genius network Mastermind? (If you were referred to us, please indicate by whom):
About You:

Your Background

Your Accomplishments

Your Goals
About Your Business:

What Your Business Sells or Provides

Niche or Target Market

Business Goals (where do you want to go with your business)
Where Are You Right NOW in Your Business?
What Would You Say Your Biggest "Pain" or Obstacle Is?
List Up to 5 Challenges You Would Like Help With (personal or business):
Have You Participated in a Mastermind Group Before?
Yes   No
If Yes, Who With?

What Did You Like/Dislike About that Group:
Why Do You Want to Join Joe Polish's Genius Network Mastermind?
How Would You Rate Yourself as an Effective Marketer (1-5)?
(1 - Terrible, 5 - Rockstar)
If you Asked Personal Friends and Colleagues What They Thought You Were Best At (What Your Unique Ability is), What Would They Say?
Please List 3 Benefits You Could Contribute to an Exclusive Group Like This:
I understand Joe's Genius Network Mastermind is an elite and high profile group which includes industry transformers from all over the world that divulge industry secrets, reveal invaluable marketing and business strategies & advice, and openly share unique intellectual capital;  therefore I am willing to sign a confidentially agreement to protect members of the group, as well as myself if I am accepted.
I agree   I do NOT agree
I understand and meet all the following requirements to be considered for Joe Polish's Genius Network Mastermind Group:  My organization brings in a minimum of one million dollars per year in revenue and/or my personal net income is currently at least $300,000 per year.  Investing $25,000 for the development and improvement of myself and my business through Genius Network Mastermind is not a burden.
Yes   No