1:1 Business Coaching & Mentorship Application
Email *
First Name *
Last Name *
Preferred Pronouns *
Age Range *
Phone Number (Including Area/City Code & Country Code) *
Where do you live? (City, State, Country) *
Instagram handle *
FB Profile Name URL *
How did you find out about working with me? *
Are you (please check all that apply)? *
Do you own an online business? *
Do you own a brick and mortar (e.g. facility for your business)? *
What is your niche/specialty and who is your ideal client? If you don't have clarity on your niche audience or target client, what do you think will help you gain that clarity? *
What is your current average monthly revenue for your business? *
How much monthly revenue would you like to be making in the next 6-12 months? *
How much monthly revenue would you like to be making in the next 6-12 months? *
What is your #1 business goal that you wish to accomplish in the next 6-12 months? Specifically how much income would you like to make, impact you would like to create, or change you would like to make? *
What do you struggle with in terms of reaching this goal? *
What is the biggest obstacle you're facing with growing your business and/or making the change that you need to make to achieve your goal? *
On a scale of 1 (not important) - 5 (extremely important), how important is it to you to achieve your goals and overcome your current obstacles? *
(not important)
(extremely important)
Business coaching is a significant investment in time, money, and personal development. Knowing this, on a scale of 1-5, how ready and willing are you to invest the time, money, and energy it takes to show up and do the work to build, change, and grow your business, as well as yourself in the process? *
I'm not ready. I'm content.
SIGN ME UP! I want to OWN my POWER!
Have you done any personal/self development work before? e.g. Identifying, working through, and overcoming limiting beliefs about money or self-worth? *
Have you invested in a business coach or business coaching program before? *
If yes, how much in total across all programs and courses have you invested? (Insert total $$ amount) *
Based on your financial situation right now, and knowing that investing in a coach means that you could triple or quadruple your income (or even more!!), and give you the financial and personal freedom you dream of, how much are you willing to spend per month for coaching (select all that apply)? *
For fun :), What is your walk up/out song? *
A copy of your responses will be emailed to the address you provided.
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy