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Full Name

Phone *

Email *

Business Name *

Location (City & State) *

Have you already started the licensing process?

Yes, but I’m stuck

I’ve done research, but haven’t started

No, I need full guidance

What’s your ideal launch timeline?

30–60 days

3–6 months

6+ months

I’m still exploring

What best describes your current situation?

I’m ready to invest in professional support

I’ve been dreaming about this but need a property and clarity

I’ve tried on my own and now need expert help

Why do you want to open your own licensed facility?

What challenges are currently holding you back?

If accepted into this program, what results would you love to see?

Are you ready to invest in a premium startup experience that includes hands-on help with everything from structure to setup?

Yes

No

Is there anything else you’d like us to know before we review your application?

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