Personal Brand & Image Questionnaire – The Total Package Program Please fill out this form so that I may better serve you. It is very important that you answer the questions with as much specific information as possible. Name First Last Email PhoneAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Skype IDWhat is the best way for us to communicate with you, phone, text or email?Do you prefer an eReader or hard/paperback books?BirthdayMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920How did you hear about JuliAnn Stitick?Are you working with a business coach(es)? Who?What is the big picture vision for your business?What do you do for fun?What publications do you read on a regular basis?What philanthropic organizations do you support?What are the top three stores you shop for clothing?Why is now the right time to up level your personal brand?In your opinion, what elements of your personal brand need polish?What is your area of expertise?What is the core message you are teaching?Does your core message align with your beliefs?What are your top 5 personal values? Do you have a value statement? If so, what is it?Are you clear on whom your customers and target market are?What makes you unique?When people work with you, they can expect ______. (Name some benefits)Has your brand changed in the last year?What changes do you know you need to make?Who are your competitors? (include links to sites)Name a few personal brands/brands that are attractive to you and why. (include links to sites) NOTE: They can be anything. For instance, I love Apple, Barbara Corcoran and M. Gemi Shoes.Is your web site/blog reflecting your personal brand, message & image? Please include a link to your site(s).Does your social media presence reflect your brand? Include links to all of your social media outlets- LinkedIn, Facebook, Twitter, Youtube, etc.Do all of your marketing materials express your brand message & image? (Business cards, brochures, etc.)When writing content, is your personal brand woven throughout?Are you concerned about being more VISIBLE due to fear or uncertainty?Are there any questions we should have asked you? Tell us more. Δ