APPLICATION FORM

Hello! Thank you for showing interest and taking the next step to increase your business profits! Please fill out this short application, just so we can get to know your situation better. Then, on the next page, you'll book a call with one of specialized team member to review your application and see how we can help you maximize you margins! . ~ Ben & Jeremy

Answer the following questions and click "Submit"

First Name *

Last Name *

Address *

City *

State *

Postal code *

Email *

Phone *

What is your company name and position? *

What best describes your business? *

Design Build

Remodeling Mainly with Some Home Builds

Craftsman Style Home Builder

Home Builder Needing Another Revenue Stream

Just starting out and researching

What size of projects does your license and insurance cover? *

Kitchen Remodels & Cabinets

Framing Only

Home Building

Remodeling

What scale of projects does your insurance cover currently? *

Less than $250,000

$250,000 and up

What was your gross revenue in 2023? *

$0-1 Million

$1-5 Million

$5 Million+

What kind of projects do you preferably want to work on? *

Residential

Commercial

What kind of residential projects do you preferably want to work on? *

Spot shot, in and out $0-250K

Mid-range $250K-$500K

High Mid-range - ave. job being $500k-$1M

Luxury - ave. job being $900K

What kind of commercial projects do you preferably want to work on? *

Retail only

Industrial

Multifamily

What are your revenue goals for the next 12 months? *

$0-1 Million

$1-5 Million

$5-10 Million

$10 Million+

Tell us why you are most interested in working with Ben and Jeremy and Rehab Revolution? *

Disclaimer - This presentation will give you actionable steps to scaling a successful coaching or consulting business.

Results are not guaranteed or typical. In fact, a lot of hard work is involved. At the end of the training, an opportunity will be offered to learn more.

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Melbourne, FL 32940