Application form

We only release a small number of memberships at a time. To be best positioned to be contacted for an interview, we recommend you complete your application form now.

(Time: approx 10-15 mins)

First Name

Last Name

Email Address

Phone number

What is your website URL?

What has been your greatest business achievement?

What has been your second greatest business achievement?

What has been your greatest personal achievement?

Describe in one sentence what you do?

How many employees (or contractors) do you have?

What is your annual revenue?

How did you hear about us exactly?

What is the most enticing aspect of Empress to you?

What are three things you would like to achieve in business and life in the next 3 years?

Describe a defining moment in your life?

What one thing is on your bucket list?

If you could study with anyone, anywhere, on any topic - who would it be and why?

12 + 13 =