Application - Reintroducing The Gentleman

Reintroducing The Gentleman

Ready to Level Up Your Life? Apply Below!

Reintroducing the Gentleman™ – Client Intake Questionnaire

Welcome. This exclusive program is designed for discerning men who are ready to elevate their style, presence, and influence on every level. Please answer each question thoroughly and honestly. All information is strictly confidential.

Reintroducing the Gentleman™
Client Intake Application

Personal Information

Full Name

Phone

Date of Birth

Home Address

Professional & Lifestyle Background

Current Occupation / Title

Company / Industry

Annual Income Range

Under $100K $100K – $250K $250K – $500K $500K – $1M+

Marital / Relationship Status

Do you have children?

Lifestyle & Identity

What are your top 3 hobbies or passions outside of work?

How do you currently describe your personal style?

Where do you feel most confident in your life right now?

Where do you feel least confident?

How do you typically spend your downtime (weekends, evenings)?

What do people usually compliment you on?

What do you wish people noticed more about you?

Program Fit

Why do you want to join Reintroducing the Gentleman™?

What does “being a gentleman” mean to you personally?

Where do you feel your current image or presence is holding you back (business, relationships, lifestyle)?

What is the #1 transformation you’d like to experience through this program?

What would success in this program look like for you, 6 months from now?

Financial & Commitment Readiness

Are you ready and able to invest $15,000 in yourself at this time?

Yes, absolutely Yes, with payment plan options No, not at this time

Are you willing to commit your time, focus, and energy to fully engage in this experience?

Yes No

On a scale of 1–10, how important is it for you to transform your style and presence right now?

Final Reflection

What inspired you to explore this opportunity today?

If we move forward together, what do you want me to know about who you are, your values, and what drives you?

Who referred you?

This questionnaire is the first step in your journey of refinement. Your answers will help determine whether you are ready to embody the next evolution of yourself as a true gentleman.

Reintroducing The Gentleman

Reintroducing the Gentleman™ – Client Intake Questionnaire

Reintroducing the Gentleman™ Client Intake Application

Reintroducing the Gentleman™
Client Intake Application