Application for Mentoring - Lara Bezerra

Welcome!
I’m honored you’re interested in my mentoring program. This form helps me understand your needs and see if we’re a fit. Answer openly so I can support you best. Questions? Text +1 (407) 861-0151.

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* 1. Address

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 2. What is your actual occupation?

I am an executive - CEO or C-level

I am a board member

I am an executive, Management level

I am an entrepreneur, I have my own business

Other (please specify)

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* 3. Is your company paying for you?

Yes

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* 4. Are you looking for a mentoring program or one individual conversation?

Mentoring program

One individual conversation

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* 5. What would you like to transform in your life?

I want to align my work with my life’s purpose.

I want more balance in my life.

I am in an important role and need to be fulfilled.

I want to improve my leadership impact.

Other (please specify and justify)

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* 6. Why did you choose my program specifically? What unique opportunities do you see it creating for your personal or professional life?

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* 7. Why do you believe that working with you will allow me to create the greatest impact for the world?

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* 8. What are your top 1–3 coaching/mentoring goals?

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* 9. If our program is successful, what will be different in your life at the end?

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* 10. How long do you expect our interaction to last?

One focused conversation for a specific situation.

3 months, 1 session/month — for a targeted challenge.

6 months, 1 session/month — for deeper transformation.

Indefinite — I see value in ongoing mentorship (please explain).

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* 11. What is your budget for investing in this area of your life?

I am ready to invest whatever is needed for the right program.

I can commit to the full program rate of USD 1,960 per 2-hour monthly session (before taxes) for the agreed period.

I have a smaller monthly budget (please specify).

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* 12. How did you find my program?

Instagram

We worked together

Referred by a client/friend

Application for Mentoring - Lara BezerraWelcome! I’m honored you’re interested in my mentoring program. This form helps me understand your needs and see if we’re a fit. Answer openly so I can support you best. Questions? Text +1 (407) 861-0151.

Question Title

* 1. Address

Question Title

* 2. What is your actual occupation?

Question Title

* 3. Is your company paying for you?

Question Title

* 4. Are you looking for a mentoring program or one individual conversation?

Question Title

* 5. What would you like to transform in your life?

Question Title

* 6. Why did you choose my program specifically? What unique opportunities do you see it creating for your personal or professional life?

Question Title

* 7. Why do you believe that working with you will allow me to create the greatest impact for the world?

Question Title

* 8. What are your top 1–3 coaching/mentoring goals?

Question Title

* 9. If our program is successful, what will be different in your life at the end?

Question Title

* 10. How long do you expect our interaction to last?

Question Title

* 11. What is your budget for investing in this area of your life?

Question Title

* 12. How did you find my program?

Question Title

* 13. Is there anything else you would like me to know before we speak?

Application for Mentoring - Lara Bezerra

Welcome!
I’m honored you’re interested in my mentoring program. This form helps me understand your needs and see if we’re a fit. Answer openly so I can support you best. Questions? Text +1 (407) 861-0151.