1. Personal Information

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* 1. Full Name

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* 2. Email address

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* 3. Phone number

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* 4. Address

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* 5. City, State, Zip

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* 6. What is your occupation?

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* 7. What is your average annual income?

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* 8. Date of Birth

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* 9. Gender

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* 10. Marital Status

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* 11. Do you have kids?

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* 12. If you have kids, what are their ages (if no kids, please skip to Question 13)?

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* 13. What type of coaching are you interested in?

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* 14. Briefly, describe how you heard about my coaching services and why you would like a Strategy Session with me.

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