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If someone referred you please provide their first and last name in the field below. Or, tell us how you heard about us.

Company Name
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Street Address * City * State / Province * ZIP / Postal Code * Country *
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- Do we have permission to send you updates via SMS messages?
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Are You The Owner/CEO/Founder of this company?*
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What is your business's Annual Gross Revenue?*
Have you ever sold/owned another business?*
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- No

Number of Employees?*
What does your business offer/provide?*
What is your niche/target market?*
Where do you want to go with your business*
What are your top 5 challenges you would like help with (personal or business):*
What is the biggest danger or struggle in your business right now (what keeps you up at night)?*
Anything else we didn't ask that you feel we should know about you?

Are You Really A Fit For Genius Network®?

At Genius Network^®, we want to ensure two things:
- That you’re the right fit for our culture
- That we can help you maximize your business and life by at least 10X
If you are not a powerful fit for the culture here at Genius Network^®, then you will not be able to experience the full benefits and transformation available in this group. In order to protect the integrity of the group, we have a screening process to ensure only the right people get in. We want to ensure that this is an extraordinary experience for those who fit this group.
How Would You Rate Your Level of Personal Ambition (1-5)? (1 - Everything important is in the past, 5 - You continually expand your vision)
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How Would You Rate Yourself As A Driven-Doer (1-5)? (1 - Worried about increasing expenses, 5 - Daily seeking bigger measurable results)
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How Would You Rate Yourself As A Generous Giver (1-5)? (1 - You focus on what you can get, 5 - You focus on giving, gratitude, and growth)
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How Would You Rate Yourself As A Fun Achiever (1-5)? (1 - You are caught in confusing complexity, 5 - You use humor to solve challenges)
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How Would You Rate Yourself In Your Respect For Marketing (1-5)? (1 - You avoid it and lack confidence, 5 - You know that marketing is the fastest, easiest and biggest multiplier)
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How Would You Rate Yourself In Your Coachability (1-5)? (1 - You have a hard time learning from others, 5 - You come with a complete student’s mindset and you immediately apply what you learn)
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How Would You Rate Yourself In How You Lead By Example (1-5)? (1 - You prefer to share stories of past success and theory, 5 - You are constantly implementing new ideas and leading your industry in innovative solutions and results)
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Please Confirm The Following Statement:*
Yes! I’d like to receive PWA's Newsletter full of Elegant Ideas and Strategies to Create an E.L.F. (Easy, Lucrative, and FUN) Business, via text message. I understand I’ll also receive relevant offers. 14 messages a month. Standard message and data rates may apply.
- I Agree
References: Please provide two business references that will vouch for your character, credibility and integrity.
- Reference 1 - Name
- Reference 1 - Email
- Reference 1 - Relationship
- Reference 2 - Name
- Reference 2 - Email
- Reference 2 - Relationship
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Achieve the Success You Desire!

PWA provides a full range of services designed to meet your organization’s needs to adapt to the new digital-technical workplace. We equip you with practical tools that enhance your organization’s competence, prepare leaders and employees to embrace change, maximize employee engagement, and ensure financial objectives are met. We are committed to your success.

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