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* 1. Name:

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* 2. Email:

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* 3. Phone:

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* 4. Where are you in your life right now?

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* 5. How do you think positive psychology will help you?

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* 6. What do you hope to get out of this course?

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* 7. What do you think your top strengths are?

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* 8. Have you done other programs with Emiliya before? If so, what programs?

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* 9. Have you ever worked with a coach before?

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* 10. How committed are you to making positive changes in your life?

This program is intended to be highly interactive where you learn through application with like-minded growth and flourishing seekers. Therefore the sessions are done over the phone and you get to speak with other members.

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* 11. How important is it for you to see Emiliya via webcam during the teaching part of the program?

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* 12. How important is it for you to be able to see other members during sessions?

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* 13. Do you have a webcam?

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