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.

Question Title

1. Address (Required.)

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? (Required.)

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? (Required.)

Yes

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4. Are you looking for a mentoring program or one individual conversation? (Required.)

Mentoring program

One individual conversation

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5. What would you like to transform in your life? (Required.)

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? (Required.)

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

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8. What are your top 1–3 coaching/mentoring goals? (Required.)

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

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10. How long do you expect our interaction to last? (Required.)

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).

Question Title

11. What is your budget for investing in this area of your life? (Required.)

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).

Question Title

12. How did you find my program? (Required.)

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 (Required.)

Question Title

* 2. What is your actual occupation? (Required.)

Question Title

* 3. Is your company paying for you? (Required.)

Question Title

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

Question Title

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

Question Title

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

Question Title

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

Question Title

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

Question Title

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

Question Title

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

Question Title

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

Question Title

* 12. How did you find my program? (Required.)

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.

1. Address (Required.)

2. What is your actual occupation? (Required.)

3. Is your company paying for you? (Required.)

4. Are you looking for a mentoring program or one individual conversation? (Required.)

5. What would you like to transform in your life? (Required.)

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

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

8. What are your top 1–3 coaching/mentoring goals? (Required.)

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

10. How long do you expect our interaction to last? (Required.)

11. What is your budget for investing in this area of your life? (Required.)

12. How did you find my program? (Required.)

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