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Client Details

Program Start Date *

Business Name *

State Business is Registered *

EIN- Tax ID *

Business Address *

Owner Name *

Primary Phone *

Owner Address *

Primary Email *

Coaching Program Details

✅ Strategic Planning Sessions

✅ Coaching Sessions

✅ Silver Bullet Academy

✅ ValueBuilder System™

✅ Team Day (if applicable)

✅ Learning Materials, Templates, and Systems

✅ Critique Services

✅ Consultations (Suppliers, Customers, Professional Service Providers)

✅ Resources and Services

Coaching Programs Overview

★ Platinum Coaching

Initial & Date for Platinum Coaching Program

Clear

* 1.Time invested will need to be applied towards the implementation of the agreed strategies and tactics. This investment can come from you or your assigned team/vendors, but you are ultimately responsible to champion the timely completion of these strategies and tactics.

2.The monthly investment is paid on the same day of each month by automatic processing of the credit or debit card on file, and in advance of the month’s services being rendered.

★ Gold Coaching

Initial & Date for Gold Coaching Program

Clear

2.The monthly investment is paid on the same day of each month by automatic processing of the credit or debit card on file, and in advance of the month’s services being rendered.

★ Silver Coaching

Initial & Date for Silver Coaching Program

Clear

2.The monthly investment is paid on the same day of each month by automatic processing of the credit or debit card on file, and in advance of the month’s services being rendered.

★ Bronze Coaching

Initial & Date for Bronze Coaching Program

Clear

2.The monthly investment is paid on the same day of each month by automatic processing of the credit or debit card on file, and in advance of the month’s services being rendered.

Terms and Conditions

Client Commitment Statement

Signatures

Signed and effective from *

Client Name *

Credit card number *

Expiration Date *

Billing Zip Code

CSV Code *