Complete the quick form below to be considered for one of this terms seats. Name* First Last Email* Enter Email Confirm Email PhoneHave you ever participated in individual or group coaching?IndividualGroupBothNeitherWhat has attracted you to me and this coaching program?What would make you the right fit, for this deeper level of work?What does your current support system look like? Friends, family, partner, etc. Do you feel well supported?On a scale of 1-10, how motivated are you in your work/personal life?1 - Not Motivated2345678910 - Very MotivatedWhat is the one thing you absolutely can’t stand doing, as a part of your work responsibilities?What is it about your work that absolutely lights you up?Tell me about your favorite place to be, on this earth.Be honest. How many times per week are you dedicating to your OWN movement practice?No Dedicated Times1-2 Times3-5 Times6+ TimesHow connected do you feel that the condition of your movement practice is to your current state of being?Recall a time of ease and flow in your life. Write as much as you can remember about the environment, people, and soundtrack of this memory.On a scale of 1-10, how large of a role are fear/anxiety about change, playing in your life?10. Fear is a HUGE Factor987654321. Fear is not a factor at allDescribe your self-care strategies.What is the largest obstacle that you face right now in relationship, to your happiness?What areas do you wish to seek improvement in right now?Check all that apply: Self-Care Teaching Practices Business Basics Work/Personal Relationships Confidence Financial Gain Business Up-Leveling Work Satisfaction Personal Health and Wellness Which of the following are most important for you to receive from your coach.Check All That Apply Gaining clarity from issues. Understanding what is important/what motivates me. Exploring and understanding what is holding me back. Gaining an insight into who I am. My strengths. Capabilities and potential. Providing encouragement and support. Helping define goals. Helping to identify action and next steps. Challenging you with difficult questions. Providing honest and direct feedback. Making you accountable for your goals. Are you available on Wednesdays between the hours of 1pm and 4pm CST?Are you prepared to allocate at least $900 of your budget for this program? Yes No Unsure This iframe contains the logic required to handle Ajax powered Gravity Forms.