Forum Chair Capability Assessment Forum Chair Capability Assessment Name* First Last Email* Phone*My vision for the future of my business.*Decide where you lie on the scale from 1 to 10. I do not have a clear vision for the future of my business. I have a clear, well-defined vision for the future of my business. 1 2 3 4 5 6 7 8 9 10 How I am currently doing.*Decide where you lie on the scale from 1 to 10. I am bored about what I am currently doing. I am very excited about what I am currently doing. 1 2 3 4 5 6 7 8 9 10 Predictable revenue from my business.*Decide where you lie on the scale from 1 to 10. I am not making enough consistent, predictable revenue in my business. I am making a lot of consistent, predictable revenue in my business. 1 2 3 4 5 6 7 8 9 10 My impact on my long-term clients*Decide where you lie on the scale from 1 to 10. I am not having as much impact on my clients as I would like. I am having significant impact on my long-term clients. 1 2 3 4 5 6 7 8 9 10 How much travel time is required to work with my clients.*Decide where you lie on the scale from 1 to 10. I am spending too much time travelling to work with my clients. I do most of my work locally with minimal travel. 1 2 3 4 5 6 7 8 9 10 The revenue potential of my local business network.*Decide where you lie on the scale from 1 to 10. I am not maximizing the revenue potential of my local business network. I am maximizing the revenue potential of my local business network. 1 2 3 4 5 6 7 8 9 10 Peer support.*Decide where you lie on the scale from 1 to 10. I feel isolated in my business. I don’t have peer support. I feel connected in my business. I have a strong peer support network. 1 2 3 4 5 6 7 8 9 10 Dream Clients*Decide where you lie on the scale from 1 to 10. I do not have enough dream clients. Most of my clients are dream clients. 1 2 3 4 5 6 7 8 9 10 Access to high quality prospects for my business.*Decide where you lie on the scale from 1 to 10. I do not have access to enough high quality prospects for my business such as speaking and networking opportunities. I have access to enough high quality prospects for my business such as speaking and networking opportunities. 1 2 3 4 5 6 7 8 9 10 Achieving my full potential.*Decide where you lie on the scale from 1 to 10. I do not feel I am achieving my full potential. I feel I am achieving my full potential. 1 2 3 4 5 6 7 8 9 10 Your ScoreWhy did you give yourself that score?* What do you think you need to do to improve your score?* What are your most important personal and business goals? What is your 3-year vision for your business?*What do you need to do in order to increase your impact on your clients, and feel greater fulfillment in your work?*What is the number one thing you need to do, starting today, in order to achieve your goals?*What business development do you do to attract clients to your existing practice? Do you enjoy business development?*Do you have any experience facilitating groups? Do you enjoy facilitating groups?*What are the top three reasons why you are interested in exploring the Forum Chair opportunity?*Disclaimer The following Top 10 list is designed to help you reflect on your trusted clients/contacts and their companies. It is meant to facilitate a discussion around how we could support you to build a ‘best fit’ group of CEO’s or executives. We do NOT use this information for any other purposes except for the conversations and coaching we provide to you.List Up To 10*Client NameTitleCompany/IndustryApprox. RevenueLocationConnection Strength List Up To 10*Client NameTitleCompany/IndustryApprox. RevenueLocationConnection Strength List Up To 10*Client NameTitleCompany/IndustryApprox. RevenueLocationConnection Strength List Up To 10Client NameTitleCompany/IndustryApprox. RevenueLocationConnection Strength List Up To 10Client NameTitleCompany/IndustryApprox. RevenueLocationConnection Strength List Up To 10Client NameTitleCompany/IndustryApprox. RevenueLocationConnection Strength List Up To 10Client NameTitleCompany/IndustryApprox. RevenueLocationConnection Strength List Up To 10Client NameTitleCompany/IndustryApprox. RevenueLocationConnection Strength List Up To 10Client NameTitleCompany/IndustryApprox. RevenueLocationConnection Strength List Up To 10Client NameTitleCompany/IndustryApprox. RevenueLocationConnection StrengthNameThis field is for validation purposes and should be left unchanged.