Before completing this application, be aware the application has three stages.

1. Completion and submission of this application form.
2. Acceptance to Stage 2 or decline of application (with referral to an alternative coach if desired)
3. If accepted, Nathan will invite you to a 30-minute telephone conversation to discuss your application and growth objectives in more detail. At the end of this consultation, both parties can determine whether or not they choose to engage in a participatory coaching relationship or not, discuss terms, availability, and start dates.

What is your full name?

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* 1. What is your full name?

What is your best contact number?

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* 2. What is your best contact number?

What is your best email address?

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* 3. What is your best email address?

What brings you to want a coach now?

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* 4. What brings you to want a coach now?

What are 3-5 main objectives you wish to accomplish by participating in a professional coaching relationship?

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* 5. What are 3-5 main objectives you wish to accomplish by participating in a professional coaching relationship?

Describe the type of engagement you think you need. (i.e. what are you looking for from the expertise you seek to hire?)

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* 6. Describe the type of engagement you think you need. (i.e. what are you looking for from the expertise you seek to hire?)

If we ultimately decide to work together, are you willing to make at least a six month investment and commitment to yourself and your personal growth and development?

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* 7. If we ultimately decide to work together, are you willing to make at least a six month investment and commitment to yourself and your personal growth and development?

On a scale of 0-100, how committed are you to improving yourself and accomplishing the outcomes you personally seek for yourself?

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* 8. On a scale of 0-100, how committed are you to improving yourself and accomplishing the outcomes you personally seek for yourself?

0 50 100
i We adjusted the number you entered based on the slider’s scale.
Is there anything else you'd like to share for us to consider in reviewing your application?

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* 9. Is there anything else you'd like to share for us to consider in reviewing your application?

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