Application for coaching sessions
Please complete this form to be considered for the coaching program. If accepted, I will contact you via email for a start date!
1. What is your name?
2. What is your age?
3. Are you married?
4. Are you a mom?
5. If "yes" to #4, how many children do you have and what are their ages?
6. What is your biggest struggle right now - your #1 problem? After that, list 1-2 others.
7. How long have you been following my blog, and why do you trust me to help you?
8. I'm excited to help and can't wait to get started! Can you commit to three 1-hour sessions on Monday, Tuesday, or Thursday evenings in November?
9. What is ONE thing you want to accomplish next year related to your struggles?
10. Answer "yes" or "no" to this question: I realize these are paid sessions and the total amount due is $97.00. I agree to pay the full amount via pay pal upon acceptance into this program with the understanding that if I am not 100% satisfied with service rendered, and upon completion of complaint form submitted within 14 days, I will receive a full refund.
Thank you! I will be in touch shortly via email. Have a great day!
I am not a licensed counselor (nor do I play one on tv). My credentials are: successfully raising 4 kids to adulthood and building solid relationships with them and each other, I hold a BA in Bible and Music, I'm caregiver for my parents, and have 30 years experience in the ups and downs of married life. There's more, but you can just ask! ;)
Send me a copy of my responses.
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