Thank you so much for your interest in working with me.
Before we begin I would love to gather a few pieces of information from you.
1-on-1 Coaching Application Form
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What's your first name?
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What's your email?
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Select...
United States
Canada
United Kingdom
Afghanistan
Åland
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
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Costa Rica
Croatia (Local Name: Hrvatska)
Cuba
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Cyprus
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Denmark
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Greenland
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Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Ivory Coast
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
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Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar (Burma)
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia (Slovak Republic)
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
São Tomé and Príncipe
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
U.S. Minor Outlying Islands
U.S. Virgin Islands
Uganda
Ukraine
United Arab Emirates
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
What country are you located in?
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What's your last name?
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How about your Whatsapp number?
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What areas of life are you seeking support in?
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Briefly share your biggest challenge in your life right now.
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How does this affect you and what does this challenge prevent you from doing?
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What’s stopping you from fully accessing your full power and potential?
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Select...
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Yes
Have you ever worked with a practitioner/coach/therapist before?
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If you answered yes to the previous question, what was it for?
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Select...
10
9
8
7
6
5
4
3
2
1
On a scale of 1 - 10, with 10 being a hundred percent committed, how committed and serious are you about investing your time, energy and resources in order to create the life that you desire?
Great! Only a few questions left. I have many payment options as my desire is to serve my community in a way that fits well and can create the best impact for you.
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Select...
$75,000+
$50,000-$75,000
$30,000-$50,000
$20,000-$30,000
$10,000-$20,000
$3,000-$10,000
$1,500-$3,000
$100-$1,500
What's your monthly income?
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Select...
I am ready and I currently have the financial resources to invest in myself.
It’s a stretch. I have some, but I would like to generate even more financial resources to invest in myself.
I'm currently not in a position to invest in myself right now.
How ready are you to invest in yourself?
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How did you find me?
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Select...
Male
Female
Non-Binary
Other
How do you identify?
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Submit
mail
What's your first name?
mail
What's your last name?
mail
What's your email?
mail
How about your Whatsapp number?
settings
Select...
United States
Canada
United Kingdom
Afghanistan
Åland
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Cook Islands
Costa Rica
Croatia (Local Name: Hrvatska)
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Ivory Coast
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar (Burma)
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia (Slovak Republic)
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
São Tomé and Príncipe
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
U.S. Minor Outlying Islands
U.S. Virgin Islands
Uganda
Ukraine
United Arab Emirates
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
What country are you located in?
settings
What areas of life are you seeking support in?
settings
Briefly share your biggest challenge in your life right now.
settings
How does this affect you and what does this challenge prevent you from doing?
settings
What’s stopping you from fully accessing your full power and potential?
settings
Select...
No
Yes
Have you ever worked with a practitioner/coach/therapist before?
settings
If you answered yes to the previous question, what was it for?
settings
Select...
10
9
8
7
6
5
4
3
2
1
On a scale of 1 - 10, with 10 being a hundred percent committed, how committed and serious are you about investing your time, energy and resources in order to create the life that you desire?
Great! Only a few questions left. I have many payment options as my desire is to serve my community in a way that fits well and can create the best impact for you.
settings
Select...
$75,000+
$50,000-$75,000
$30,000-$50,000
$20,000-$30,000
$10,000-$20,000
$3,000-$10,000
$1,500-$3,000
$100-$1,500
What's your monthly income?
settings
Select...
I am ready and I currently have the financial resources to invest in myself.
It’s a stretch. I have some, but I would like to generate even more financial resources to invest in myself.
I'm currently not in a position to invest in myself right now.
How ready are you to invest in yourself?
settings
How did you find me?
settings
Select...
Male
Female
Non-Binary
Other
How do you identify?
settings
Submit
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