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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 goals do you want to achieve over the next 3 or 6 or 12 months?

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* 4. What are the 3 biggest changes you want to make over the next 3 years?

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

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* 6. What have been your 1-3 greatest successes to date?

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* 7. What is the greatest challenge you have had to overcome? 

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* 8. Please rank the below statements in order from 1-10 (10 being the most important) of what you hope to achieve throughout your 1:1 coaching sessions.

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* 9. On a scale of 1-10, how motivated are you mentally and monetarily (minimum of $500/session) to working with a life coach? (1 being the least, 10 being fully-committed)

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

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