1 on 1 coaching with Cheryl Himburg Application for the CEO Accelerator coaching program. Yes Cheryl! I want to partner with you and gain full access to your coaching, network and expertise. I understand that you will use this application to select action-oriented, like-minded women who are looking to grow and develop in their career or business. I understand that I will be notified within 5 business days to arrange a call via phone or zoom to discuss my challenges, goals, and see if we are a perfect fit! All information submitted on this application is kept strictly confidential. I understand that by completing this application, I am showing interest in the CEO Accelerator program and am under no obligation to accept or make payment. Your Name (required) Business Name Website # of Years In Business Career Role (required) # of Years in Role or Industry Street Address Address Line 2 City Province/State/Region Postal Code/Zip Country (required) Your Email (required) Your Phone (required) Please describe your business and life as it is right now. What exactly are you struggling with? What are the top 3 goals you'd like to achieve by working with Cheryl? What do you think is your biggest obstacle in reaching your goals? What's stopping you or slowing you down? What is it costing you to NOT achieve your goals? Be specific and consider in terms of lost money, time, relationships, family, health and happiness. What is your WHY – your motivation for doing the work you wish to do in the world? What are your top 5 strengths, gifts or natural tendencies? (These are likely what people often thank you for and come naturally and easily to you.) What is your approximate gross annual revenue? (This information is kept strictly confidential) What is your goal gross annual revenue in the next 12 months? What take-home income would you like to reach in the next 12 months? I limit the number of one on one coaching spaces because I fully invest in the growth and development of those I partner with. Therefore, I am looking for people who are ready to dig in, get uncomfortable, and do the work for AMBITIOUS RESULTS. Please share a bit about why you are ready and feel we’d be a good fit. Acceptance: (required) I understand by filling out this application, I am requesting a discovery call with Cheryl Himburg regarding the CEO Accelerator program. At this point in time, I understand I am showing interest only in the program and am under no obligation to join or make payments. Earnings Disclaimer: We’ve taken every effort to ensure we accurately represent the CEO Accelerator offering and the ability to help you grow in your career or business. Each person’s results will vary. You alone are responsible for your actions and results which are dependent on personal factors including skill, knowledge, ability, dedication, business savvy, network and financial situation, to name a few. There is no promise or representation that you will make a certain amount of money, or any money, as a result of using our programs and services. Any earnings, revenue, or income statements are strictly estimates and there is no guarantee that you will make these levels yourself. If you have any questions, please contact our customer support team at email@example.com.