1:1 Private Mentoring Application Name * First Name Last Name Email * Age * Phone * (###) ### #### Location * Website URL (if you have one) http:// What is your profession? * How did you hear about my work? * Why are you seeking coaching at this time? What is the thing that matters most to you right now in your life that you want to create or experience more of? * What are the top 3 things you perceive as getting in your way from having the goal(s) you identified? * On a scale from 1-5, how willing are you to invest in yourself? and do what it takes to build the life you want in an authentic way? (1 being not very much to 5 being I’m so committed to doing this regardless!) * Strongly Disagree Disagree Neutral Agree Strongly Agree Why is now the right time? * What do you see yourself accomplishing as a result of coaching? All of my Private Mentoring and Coaching programs are for Women who are ready to take actions towards their dream life. There is a tuition investment to participate and be selected into one of these programs. Select the statement below that best describes your current level of commitment to make an investment in yourself with a full YES and no stories.. just a focus on getting results. (Your answer to this question doesn't obligate you to anything and if you're selected for a private consultation to review your application, different payment options will be available to you) * I have the necessary financial resources to invest in myself. I have the ability to get the necessary financial resources to invest in myself. I don't have any financial resources available to do anything different then I'm already doing. Thank you!