Application to work with me - Mindset Reset  programme.
Sign in to Google to save your progress. Learn more
Email *
Your name *
Why do you think this is the right time for you to go through the Mindset Reset Programme? *
What would you like to resolve in either your Professional or your personal life right now? *
If you are accepted onto the 3 month+ programme, are you ready to fully commit to making time to go through it for the next 14 weeks? *
How have you tried to resolve this issue/issues in the past? *
Have you worked with anyone in the past to help you resolve this time issue? *
Do you agree that your are responsible for the actions you take during this 3 month+ programme to bring the necessary changes needed to make a difference in your situation?   *
Do you agree that you have the funds to pay for this 14 week programme without putting yourself into financial difficulty when paying in full or using the payment plan? *
Thank you so much for applying to work with me, I will be in touch shortly to let you know if your application has been accepted at this time.  If for whatever reason I have decided it is not the right time for you, would you like me to contact you again to check in and see if your circumstances have changed to allow you to go through the intensive programme?   *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms