Build your Child's Emotional and Academic Resilience (Free Clarity Session)

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Hello, and thank you for taking the time to fill out this form. Ebiere will get in contact with you after reviewing your form.

This FREE session is for parents who are worried about their child’s emotional or academic resilience and want to repair and strengthen the relationship with their children, so as to enable the child develop positive relationships, personal mastery, academic prowess and a sense of purpose and meaning in life; now and in adulthood.

Kindly answer the questions below as honestly as possible so that I can have better insights as to how to help you achieve your desired parenting goals.

Email *

Do you want to upgrade your free 30 minute clarity session to one hour? You can do so by paying £35. Click here to upgrade: https://www.raisingyourchildonpurpose.com/upgradefcs

You can return to complete the form afterwards

Full name *

Country of residence *

Mobile number *

Gender *

Female

Male

Prefer not to say

Other:

Age range *

20 - 29

30 - 39

40 - 49

Over 50

Relational information *

Married and parenting with spouse

Single and shared parenting with ex-partner

Single and parenting alone

Blended family

Other:

Number of children, ages and gender

Boy

Girl

0-2

3-6

7-10

11-14

15-18

Child 1

Child 2

Child 3

Child 4

Child 5

Working arrangements (Tick as many as apply to you)

in Full-time work

Part-time work

Business owner

Stay at home parent

Father

Mother

Job Title of both parents *

How would you describe your style of parenting? Choose your most dominant parenting style from the standard list below. If unsure, click other and describe your parenting style as best as you can. *

Authoritarian or Disciplinarian

Permissive or indulgent

Not too involved

Authoritative

Other:

Required

Describe in some detail, your relationship with your child(ren)? *

Which area(s) of parenting do you find you need help with the most? (Tick as many as possible and include others if necessary) *

Behaviour (Discipline)

School (this may include career/university choices)

Connection with you

Sibling relationship

Parenting with spouse

Emotional resilience of child

Character development (e.g. responsibility, independence, resilience etc)

Managing your emotions

None, I've got it all covered

Other:

Required

Describe an ongoing parenting challenge you are facing? *

How are you handling the situation you described above? *

How confident are you that your approach will yield your desired outcome for your child(ren) *

Not confident at all

Very confident

How do you feel when you can't effectively handle a situation with your child(ren)? *

What are your biggest fears with regards to parenting? *

What have you tried to do recently to improve your parenting, but hasn't worked? *

Have you ever sought professional help with parenting? *

Yes

How likely are you to pay for coaching to help you achieve your parenting goals? *

Not likely

Very likely

How willing are you to parent without seeking professional help to ensure you achieve your desired goals? *

Willing to go it alone

Not willing to risk it

Paint me a picture of you, achieving your desired parenting goals in 6 months. What does this look like? *

What are your expectations from this 30 minutes session with me? *

Have you paid the optional £35 to upgrade your 30 minute free clarity session to 1hr? *

Yes

How did you hear about this FREE clarity session with me? *

Send me a copy of my responses.

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