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Application for Recovery@Work VIP Coaching Program with Maureen Ross Gemme
Shall we work together to make your career dreams come true?
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Email
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Your email
What is your full name?
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Your answer
What is your cell phone number?
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Your answer
Explain your current work situation as it is now.
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Your answer
Now share what type of career or job you want to step into. No vision or goal is too lofty. It's also okay to be unsure but know you want more clarity and need help to figure out your next move.
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Your answer
What have you tried before to improve your situation but has NOT worked?
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Your answer
Are you willing to spend 2 to 3 hours of work on your personal growth each week and make it a priority in your life to get the results you want?
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Yes
No
Maybe
What results would you have to achieve in order to feel the program was a success?
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Your answer
Why do you think I might be the right coach for you?
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Your answer
What else would you like me to know about you?
Your answer
Would you be able to meet with me during weekdays sometime between 8AM - 5PM ET? (On Zoom)
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Yes
No, but I could meet in the early evening or on Saturday morning.
It's complicated, I'll explain when we talk.
On a scale of 1 - 10, how motivated are you to change your situation?
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I don't care, I'll stay here forever.
1
2
3
4
5
6
7
8
9
10
I'm highly motivated and will do just about anything!
Anything else you'd like to say?
Your answer
A copy of your responses will be emailed to the address you provided.
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