1-on-1 Coaching Application with Stefano
I only work with a few clients at a time to ensure the best possible experience. Please complete the application below to help me get a better sense of what your specific goals and challenges are.

After reviewing your application, if I think we might be a good fit, I'll contact you within 2 business days to let you know how to proceed.

* I want to learn as much as possible about you so that I can provide you with the most value for your specific needs. Please be detailed and specific with your answers.

First Name
Your answer
Last Name
Your answer
Email
I will reach out to you through this email address. Make sure it's the best address to reach you.
Your answer
Skype Username
Your answer
Phone (only to be used in the case that you don't have Skype)
Your answer
Birthdate
MM
/
DD
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YYYY
What are the top 3 things you're currently struggling with?
Your answer
Of those 3, which do you want to change the most? Why?
Your answer
What have you tried doing in the past? What has worked for you and what hasn't worked?
Your answer
What's the #1 goal that you'd like to accomplish in the next 3-6 months?
Your answer
Why haven't you accomplished that goal yet? (Seriously...)
Your answer
Financial resources:
Anything else you'd like me to know before considering you?
Your answer
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