Screening Questions Mastermind Name * First Name Last Name Email * Phone * (###) ### #### Where are you located? * City and State please Have you ever participated in a mastermind group? * YesNo If you were going to create a ‘dream team’ of people to brainstorm with you, what would you look for in the people? * What are your expectations about what membership will do for you? What are your personal and professional goals this group can help with? * What is the biggest challenge your facing right now that the mastermind group could help you with? * A Mastermind Group can only be good if it has good members. Why are you a good choice for this group? * Do you agree that missing one meeting a month is acceptable but any more than that could generate a request to leave the group? Yes No Are you highly-motivated, willing to help others, and also looking forward to help. * Yes No Do you take your commitments seriously? * Yes No What day would you like to meet? * Monday Tuesday Wednesday Thursday Friday Saturday Sunday What time would you prefer to meet? Hour Minute Second AMPM Thank you! I appreciate your interest in this group. We are trying to keep the group small in an effort to increase the benefit to all involved. Expect a follow-up email in the first week of November.