Mentorship Application
This form is designed to help you describe your situation so that I can assess how to best assist you.

Please take the time to give as much information as possible. This form shouldn't take longer than 10 minutes to complete. After reviewing your application I'll be in contact with more information & details regarding the options for working together.

VERY IMPORTANT: Please ONLY use this form if you are serious about working with me as your mentor in the next 30 days (or 3 months if you are looking for in-person coaching), and you have funds and time available (pricing information is below in the form). If you have specific questions you'd like me to answer before proceeding, please email me at or contact me directly through Facebook messenger.

Email address *
Your full name *
Please tell me a little about yourself *
Your age, where you're from, what you do for a living, what type of character you are, how do you spend your free time etc
Thank you for your interest in working with me. What is it about my teaching in particular that resonates & why do you feel we would be a good fit to work together? *
Which format of mentorship are you interested in? *
What are your goals and how far are you from reaching them? *
Please explain how your ideal social & dating situation would look.
Please describe your situation at hand, including what you've tried so far.
Which of the following are you good & not so good at? *
Definitely need help
Ok sometimes
No problem, I'm fine at this
I'm an expert
Maintaining a healthy level of self-esteem
Breaking the ice with strangers
Keeping a conversation going
Keeping calm in social situations
Holding peoples' interest/attention
Establishing new friendships & connections
Approaching/starting conversations with women
Getting along with/taken seriously by women
Being treated well by/gaining respect of other males
Letting women know you're interested in them
How do people generally respond to you/how do your first encounters with new people usually go? *
Which of the following is most important to you at this stage in your life? *
Tick all that apply to you.
What's the biggest thing that's holding you back right now? *
Tick all that apply to you.
How serious are you about starting the process of getting this area of your life handled? *
I'm happy with my current situation
It's a big priority for me at this time
Please confirm: I am seeking expert help, I have funds and time available to sign up immediately for a training programme if I feel that one of your programmes is the right fit. *
A copy of your responses will be emailed to the address you provided.
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