Application

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Where are you based?
Location
4
How did you hear about me?* This field is required.
Instagram
TikTok
Facebook
YouTube
LinkedIn
Email
Referral
5
What do you need help with?* This field is required.
Life Coaching
Career / Business Coaching
Both
6
What challenges are you currently facing in your career?* This field is required.
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7
What's holding you back from achieving your career / business goals? What hurdles are you running into?* This field is required.
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8
What's holding you back from being the person you want to be and living the life you want? What hurdles are you running into?* This field is required.
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9
What have you tried so far to achieve your career / business goals? What results have you accomplished so far?* This field is required.
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10
What have you tried so far to create the life you want? What results have you accomplished so far?* This field is required.
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11
Take a moment and daydream for a minute...1 year from today, what does your life look like?* This field is required.
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12
Why now? Why are you ready for change?* This field is required.
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13
How committed are you to your goals on a scale of 1-10?* This field is required.
14
If you're accepted into my coaching program, how soon can you get started?* This field is required.
15
If you were given the blueprint to completely transform your life, and it required a minimum investment of $3600 USD to put all the pieces together, would you do it?* This field is required.Please note that actual cost of coaching is based on the type of coaching you need.
Yes, I have the financial resources
No, I don't have the financial resources available to me
16
I only accept clients who are serious and committed about their efforts. Given that you've come this far, it may seem a bit odd to ask but will you show up for the call if your application is accepted?* This field is required.
Yes, I'll be there
No, I'll cancel or not show up
17
If your application is accepted, please note that our call will be done using Zoom voice and not your phone number (we won't be on video for this initial call). You'll receive a link to join the call in your email inbox. Please check your inbox right after this for a confirmation email.* This field is required.
Yes, I understand and will check my email
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