Becoming A First Time Author Connect Group Intake Form
Thank you for your interest in this coaching experience. It is my honor to come along side you in your endeavor towards Becoming A First Time Author. If selected to be apart of this coaching program, our goal is to provide information that will exceed your expectations and be value adding experience for you.

To get started please take a moment to complete the following intake information.



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Email *
Birthday *
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Name *
Best contact number? *
Group Leader: Clifton C. Manning
Favorite wine? *
Favorite food indulgence? *
Identify your interest (you can select more than one): *
Required
Have you worked with a coach in the past? *
If yes to working with a coach in the past what was that experience like? *
How long have you desired to write your first book? *
What three goals would you like to achieve with this Becoming A First Time Author coaching program (30/60/90) *
On a scale of 1-5, 5=High, provide the number that represents your level of commitment to actively participating in the coaching process? *
On a scale of 1-5, 5=High, provide a number that represents your willingness to invest in coaching that will accelerate your movement towards becoming a first-time author? *
On a scale of 1-5, 5=High, provide a number that represents how coachable you believe you are? *
If you are a 4 or below on any of the above questions, please be transparent and tell us your real feelings as to why you don't see yourself as a 5 and what you plan to do to change that reality. *
What has been your greatest struggle in achieving your dream of becoming a first time author? *
What has been your greatest accomplishment in your life to date? *
Your financial disclosures will be kept confidential.  What is the approximate Net Worth of your business: *
Annual Income: *
At the end of the program you enroll in, if expectations are either met or exceeded, would you be willing to supply video testimonial(s) of what you enjoyed most about your experience? *
If you are selected as a good fit for the  coaching program, do we have your permission to contact you to set up a free consultation call? *
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