Private Coaching Application
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What is your name *
What is the best email for me to reach you? *
Have you ever worked with a coach before? *
Tell me 5 things I need to know about you *
What do you spend the majority of your time on? *
Tell me about your business or job *
Please link your website and/or social media channels below.
What are you looking to create in your life right now? *
Is your partner or family/friends supportive of your personal growth?
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On a scale of 1 - 5 (5 being super serious), How serious are you about investing time, money, and energy into creating the life you want? *
In order for me to know what type of my services and support levels are a match for what you're looking for it is important that I'm aware of what monthly financial commitment you are able/willing to make at this time. *
Private Coaching $3000
What is your favorite way to learn?
What area do you feel like you give the least amount of consistent attention to in your life? *
When was the last time you did something for yourself, something that makes YOU happy? And what was it? *
If you could describe your life right now using one word, what would it be? *
What are you looking for from a coach? *
What made you reach out about coaching right now? *
Tell me what mindset means to you, and if you currently have a mindset practice, what is it? *
How did you hear about me? (If a person referred you, please put their name below) *
Thank you for taking the time to fill out this form!
This helps me get a good feel for where you're at and what you're looking for in a coach. It's important to me that not only are you a good fit for me, but am I truly a good fit for you as well. I don't work with every applicant simply because I refuse to go into any agreement where I'm not positive it's a great match and we can make the changes you're seeking together. I look forward to reviewing your responses and will be back with you shortly for next steps. Please make sure you add my email adress to your contact list so my message makes it to your inbox (

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