Welcome - thank you for applying! First, what is your full name?

What’s the best email address for us to contact you on? *

What’s the name of your business or organisation? *

Can you please share your website address and your social media handles?

Tell us about your business!

What does your business do and who are your customers? *

How long have you been in business/your position? *

What are your big-picture goals for 2023? *

Where do you see yourself/your business in 5 years - dream big here! *

What holds you back when it comes to achieving your goals? *

What do you find challenging about running your business? What’s that one thing that slows down your progress? *

How do you define success? What does success mean to you? *

What other business mentoring or mastermind programs have you participated in? *

The Roxy Jacenko Mastermind begins 6th March and requires an 8-month commitment that will include submitting your monthly goals, wins and lessons learnt each month as well as showing up on the monthly calls.

Are you able to make the time commitment to show up and fully participate? *

Yes!
I'm not sure

If selected to be part of the Mastermind, will you opt for the upfront payment of $40,000 or would you prefer to pay via the monthly instalment plan of 8 x $5333/month? *

Upfront Payment
Monthly Payment Plan

Finally, what’s the one big dream, goal or win you’d like to tick off your list by the end of the 8-month Mastermind? *

Thanks for getting in touch!

We appreciate you contacting us. One of our colleagues will get back in touch with you soon!

Have a great day!

Thanks for getting in touch!

We appreciate you contacting us. One of our colleagues will get back in touch with you soon!

Have a great day!

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