Skip to content

Menu

Member List
Upcoming Events
Presentation Library
Accountability Groups

Submit Your Application

Member List
Upcoming Events
Presentation Library
Accountability Groups

Menu

Member List
Upcoming Events
Presentation Library
Accountability Groups

Upcoming Events

CF8A6750-55C8-4168-87ED-9FF47C058F45

2021 – February 26th & 27th

Cabo, San Lucas

2021 – May 14th & 15th

Austin, TX

UAC - Park City - Montage

2021 – July 30th & 31st

Park City, UT

2021 – September 24th & 25th

Sedona, AZ

Upcoming Events
Member List
Presentation Library

Copyright © 2021 Ultimate Achievers Club Ι 1776 Park Avenue, Suite 4-217 Park City, UT 84060

Accountability Groups
Application
Application Form
Austin
Contact Us
F.A.Q.s
Home
Meet The Board
Member List
Miami 2020
Presentation Library
Presentation Library Events
Presentation Library new
Presentation Library options
Privacy Policy
Upcoming Events

Application Form

Step 1 of 3

33%

Basic Information
Name*
First Last
Email*
Cell Phone*
Chiropractic School Attended*
Year Graduated*
Please enter a value between 1940 and 2020.
Who invited you to join the UAC?*

Practice Information
Name of Practice*
Years in practice?*
Do you have more than one practice?*
- Yes
- No
How many practices do you have?*
Please enter a value between 1 and 5000.
Do you own businesses in addition to your chiropractic practice?*
- Yes
- No
What is the central focus of your practice?*
What type of business do you have to support the chiropractic profession?*
- Own a practice
- Own a business that serves the profession
- Both
Please list current annual revenue from each of these businesses*
Please list current annual revenue from each of these businesses*
Please enter a value between 1000 and 200000000.
What are your current average visits per week?*
Please enter a value between 10 and 5000.
How many employees/contractors do you have?*
Please enter a value between 1 and 500.

Digging Deeper
Who would you call your mentor(s)?*
What is your Superpower?*
What is your Kryptonite?*
What do you hope to share with the group?*
What do you hope to learn from the group?*
What do you hope to teach to the group?*