The Second Act-1:1 Coaching Program Application
Program Application
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Email *
First and last name please. *

Where in the world are you located? City/Province/State/Country?


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Tell me about your life in general…your current relationships, career, health, finances & spiritual self. 

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What are the biggest challenges you want my coaching support on? Please share and be as detailed as possible.  *
Where do you see yourself in 6 months? 12 months?  Please be specific and share any goals that you'd like to work towards. *
Why is now the right time for you to begin coaching?  *
What appeals to you about working with me specifically as your Life Coach? *

There are 3 options for the Second Act program…. The 5 month program, a 30 Day daily VOXER intensive or a Monthly payment plan of $2,500 USD, with a 2 month minimum. Which option would you prefer? 

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Is there anything else you would like to share with me about your life situation or challenges? Any questions *
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