Freedom Coaching Application
Thank you so much for your interest in working with me! I am so excited that you have the desire to fully unlock your purpose, ignite your power and restore your faith & confidence! I applaud your for taking this huge step into mental, physical and spiritual freedom!

Before we get started, please fill out this short application to ensure that this program is a good fit for you. Please answer thoughtfully, honestly, and in as much detail as possible so that I may know how best to serve you.

*Note: Completion of this form does NOT guarantee acceptance into this coaching program. Only applications completed in its entirety will be considered. Please allow at least 24-48 hours for an email response regarding acceptance.
Email address *
Full name *
Your answer
Primary phone number *
Your answer
Social Media Handles *
Instagram, Facebook, Twitter, etc.
Your answer
Professional Occupation *
In addition to job title, please include a brief synopsis of your daily responsibilities.
Your answer
Why would you like to work with me? *
Your answer
What are you most in need of right now?
Your answer
What areas do you feel the most “stuck” or unsatisfied? *
Check all that apply.
Required
What do you feel you need to be set free from in order to live your most abundant and fulfilling life? What’s holding you back? *
Your answer
What specific goal(s) would you like to accomplish by the time we finish working together? *
Your answer
How did you hear about me? *
Check all that apply.
Required
Coaching sessions are typically at least 60 minutes. How much time are you willing to commit? *
Please note: Although a standard single session is 60 minutes, our exclusive VIP Freedom Accelerator Day is one 4 to 5 hour long session.
This program starts at $250 per hour and will typically range from 1 to 4 sessions, dependent upon individual need. Are you financially ready to make this investment in yourself? *
We understand that sometimes some extra grace is needed, even when investing in your freedom. Will you need a payment plan?
If you are accepted into this program, how soon are you ready to get started? *
MM
/
DD
/
YYYY
What is your general availability for an uninterrupted 60 minute or 4-5 hour session? *
Please list daily availability from Monday - Saturday EST.
Your answer
My desire is for you to experience as much transformation, renewal and freedom as possible during this program AND after its completion. Are you ready and willing to do the work necessary in order to see lasting change in your life? *
The “work” is not limited to our 60 minute or 4-5 hour long sessions together. The person who will benefit the most from this program is one who will invest time and energy into THEMSELVES, completing all assignments in a timely manner.
Is there anything else you’d like me to know?
Your answer
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy