INSTITUTE FOR BUSINESS TECHNOLOGY
LICENSEE APPLICATION

Name: Social Security No.:
Address:
City/State/Zip:
Phone (Home): (Business):
(Fax):
E-mail Address:
Is it your intention to start a business by yourself or are you planning to work with someone else? (If the latter, please also provide information on that individual or group.)
Do you already have or are you part of a training or consulting practice? If so, please describe.

B. EDUCATION AND CAREER HISTORY

Please copy and paste a resume of your education and professional experience below.

C. In our brochure, we provide a profile of a successful IBT Licensee. This is garnered from our experience with licensees in twelve countries. Will you please briefly comment on how you match each of the points on this profile.

Motivation - The desire to grow one's own business and to do something to improve people's lives.
Time - The ability to spend AT LEAST 50% of one's time developing your marketplace.
Finances - The personal finances to spend SIX MONTHS developing your market before needing to realize a revenue return.
Sales - Capable of doing the high-volume networking and cold calling required to develop your market.
Business - Adequate experience working in organizations to speak credibly to the problems and concerns of management.
People - Genuine empathy with people that will encourage them to open up in one-on-one coaching.
Integrity - Always prepared to go the extra mile and do the right thing for clients and associates.
D. In addition to the above, it can be very helpful if a new licensee has a network of local contacts to provide initial access to the business community. Please describe what networks or resources you may have.
E. Do you hold any other business licenses or franchises now or in the past? If so, please describe those relationships.
F. Do you have or have you had any judgments against you in prior or current business relations? If so, please explain.
G. Are there any other facts you would like us to know about in considering your application?
The information provided above is an accurate representation of my professional situation and interests.
Date: Signature:

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Copyright © 1998 Kerry J. Gleeson