Your Business Success Builder

Please complete and return this Business Success Builder as soon as possible.

This questionnaire is designed to accomplish 3 things:

1) to help you get more focused for your session

2) to help you pre-think so that your session will be more productive

3) to allow us to customize the session for you to help you achieve your dreams and goals more efficiently and quickly.

The Business Success Builder includes two sections

Section 1: General questions about your goals and ownership/leadership style as well as more specific questions relating to your business.

Section 2: Prioritizing your challenges and opportunities.

Please note that this form is dynamic, in other words if you leave this page your information is not saved. 

Please complete in one sitting.

It is important for you to be as honest and accurate as you can. Please complete both sections.

Section 1


1. What type of business are you in?

6. Do you have a business plan or career plan?

If yes, how often do you compare and measure your progress to the plan?

18. Is your conversion ratio estimated or measured?

26. Please check the box that describes you most of the time.

32. Are you coach-able?

Section 2

Please Pick Your Top 5-7 Priorities Below

Sales & Marketing

Team Building & Leadership

Running Your Business



Congratulations and thanks for your time …

bill front shot

Thank you for taking the time to complete this questionnaire … it’s really important for
both of us to fully understand your current situation …that way we can be sure to put our effort into the areas of your greatest importance.

If you chose the printed version of this form:
Please Fax to 828-395-1801
or e-mail to

Bill Gilliland
P.O. Box 238,
Montreat, NC 28757

Confidentiality Note

The information contained in this questionnaire is confidential information intended only for the use of ActionCOACH and the person completing this questionnaire.

If the receiver of this questionnaire is not the intended recipient, the receiver is hereby notified that any
dissemination, distribution, copy, or publication of the questionnaire is strictly prohibited.

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Asheville, NC

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