Beyond Your Dream Board

Welcome. Let's begin.

This form helps me understand where you are, where you're headed, and how we can build something that truly fits your life and legacy.

A note before you start: As you read through this, you might think, "If I knew this, I wouldn't be talking to you." I get it. Fill out what you can. Your answers will give me insight — and they'll be interesting for you to revisit a year from now. This is completely confidential.

Contact Information

First Name *

Last Name *

Email Address *

Phone Number

Preferred Method of Quick Contact

Phone Text Email WhatsApp

Program

Background

Current Occupation / Title

Industry

Relevant Work Experience

LinkedIn Profile URL

Goal Setting

Short-Term Goals (Next 6 Months)

Medium-Term Goals (6–12 Months)

Long-Term Goals (1 Year and Beyond)

Mindset & Psychology

Risk Tolerance (1 = Very Tolerant, 10 = Very Risk-Averse)

Major Fears or Concerns About Moving Forward

Self-Identified Strengths

Self-Identified Weaknesses

What Does "Success" Mean to You?

What is Your WHY?

What Has Kept You From Fulfilling This Until Now?

Financial Comfort

Estimated Budget for Business Start-Up

Comfort Level with Financial Investment

Low Medium High

Comfort with Monetary Reserves During Launch

Low Medium High

Skills & Interests

Areas of Expertise

Special Skills or Gifts

Hobbies and Interests

Comfort with AI & Technology

What Technologies Are You Currently Using?

What AI Platforms Are You Using and How Comfortable Are You With Them?

Previous Attempts

Past Entrepreneurial Experiences, If Any

What Didn't Work in the Past and Why

Availability & Commitment

Preferred Days and Times for Sessions

Level of Commitment to the Program

Casual — I'm exploring Moderate — I'm ready to start Fully Committed — Let's go

Referral & Additional Notes

How Did You Hear About Us?

Referral LinkedIn Podcast Online Search Other

Additional Comments, Expectations, or Anything Else You'd Like to Share

This information is completely confidential and shared only with Viveka.

You're in. Thank you for taking the time to do this — it matters. Viveka will be in touch within 48 hours with your next steps. Check your email for a confirmation.

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