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Fresh Start Strategy Session
Completion of this form entitles you to a FREE Fresh Start Strategy Session AND a $500 discount on your coaching program if you sign up within 2 hours of your session.
Email address *
Full Name (and name you wish to be called) *
Your answer
Age *
Date of Birth *
MM
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DD
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YYYY
What is your time of birth (be exact if possible) *
Your answer
Place of Birth (City, State, Country) *
Your answer
Civil Status *
What is your #1 career goal this year? *
Your answer
What is your biggest professional challenge? *
Your answer
What is your biggest personal goal this year? *
Your answer
What is your biggest personal challenge? *
Your answer
What is your most important relationship? *
Your answer
How urgently do you want to change your life? *
Very urgently
Not at all urgent
On a scale of 1 to 5 what is your level of commitment (emotionally, spiritually and financially) to resolve your challenges and change your life right now? *
Very committed
My commitment is questionable
How do you know your level of commitment to resolve your challenges and powerfully change your life? *
Your answer
What, if anything would stop you from changing? *
Your answer
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