Press play button to continue
First Name
Last Name
Phone
*
Email
*
Child's Name
Press Enter/Play Button to continue
For these questions please answer using a scale of 1 - 5
1 = The Lowest Level of Effort
to
5 = The Highest Level of Effort
Press Play Button to continue
Your Child has a clear direction on What he / she is passionate about in Life.
1
2
3
4
5
Your child is involved in complimentary activities that assist in reaching his / her passion in life.
1
2
3
4
5
Your Child exercises Self Discipline in regards to his/ her physical Fitness.
1
2
3
4
5
Your Child exercise Self Discipline in regards to his/School Work.
1
2
3
4
5
Your Child exercises Self Discipline with his/her Personal Development.
1
2
3
4
5
Your Child has received training in Public Speaking.
1
2
3
4
5
Your Child understands the Importance of Storytelling in today’s world.
1
2
3
4
5
Your child exercises his / her IMAGINATION often.
1
2
3
4
5
Your Child has been introduced to the Mastermind Principle.
1
2
3
4
5
You Mastermind with your Child on a Daily Basis.
1
2
3
4
5
You use the Mastermind Principle.
1
2
3
4
5
Do you Mastermind as a Family once a day?
1
2
3
4
5
Your Child Reads Daily.
1
2
3
4
5
You Read Daily.
1
2
3
4
5
You talk about the Importance of Reading with your child.
1
2
3
4
5
Your child leads every opportunity he/she gets.
1
2
3
4
5
Your child has been taught the principles of leadership.
1
2
3
4
5
You want your child to make Personal Development a Habit starting today.
1
2
3
4
5
You understand the Value in Investing in yourself.
1
2
3
4
5
You invest in your health and wellness every month.
1
2
3
4
5
You are Excited you invested in a Mentor for your child.
1
2
3
4
5