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* 1. Please provide me with your contact information.

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* 2. Please tell me a little bit about yourself and why you are interested in working with me.

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* 3. What 3-5 areas are you currently struggling?

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* 4. Have you previously worked with a coach?

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* 5. What do you feel you need most right now?

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* 6. What would you like your life to look like in the next 6-12 months?

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* 7. Why is now the time to take action? What will your life look like if you don't take action?

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* 8. On a scale of 1-10, how motivated are you to working with a coach? (1 being the least, 10 being fully-committed)

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* 9. If we decide it's a great fit are you ready to invest in 3-months of group coaching (choose which is the best choice for you):

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* 10. Please provide any additional information you would like to share before submitting your application.

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