Celebrity Science Consult Form

Please complete this in-take assessment and Kym Yancey, Executive Producer of Celebrity Science, will be scheduled to personally consult with you.

First Name *
Last Name *

Company Name

City
State
Country

Cell Phone *

Website *

Email *

Describe what you do: *

What do you want to see happen with your brand? *

What are your top two business challenges at this time?

Business Challenge #1 *

Business Challenge #2 *

Do you currently use videos as part of your branding? *

YesNo

Do you have a logo for your brand? *

Yes, I currently have a logo.No, not presently, but am having a logo made.No, I do not have a logo.

On a scale of 1 - 10 with ten being the highest compliment you could give; how do you rate your brand as it is now? *

Is there anything else you would like Kym Yancey to know about you before your conversation? *