JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Family Play-Based Coaching Program — Are we a good fit!?! Pre-Connection Application Form :)
The first step to your 6-month family transformational coaching journey is filling this form out and booking a "30 minute connection session" (link to book at bottom of page). Don’t feel pressured to fill out every section *perfectly* (no such thing!), but just do the best you can! (It’s enough!!)
Sign in to Google
to save your progress.
Learn more
What is your name?
Your answer
Best email address?
Your answer
How did you get referred to or connected with Amanda? How did you hear about this program?
Your answer
Tell me about you and your family. What feels important to share so I can best get to know you and discover if you are a fit for this program.
Your answer
Tell me about your child(ren)! (Strengths, desires, likes/dislikes, personality traits, their spirit, areas of growth or challenges)
Your answer
What three words would you use to describe your family and relationship with your child(ren)?
Your answer
What three words would you use to describe your relationship with your own parents?
Your answer
What is your ideal vision for your life and your family?
Your answer
What is not working in your life/family right now?
Your answer
What specifically are you looking for support with or a change in?
Your answer
What have you already tried to support your family or yourself with this?
Your answer
What is so important about seeking this support and changing this NOW? What will this bring you/your family by no longer having this struggle?
Your answer
How would you feel if these things were a "non-issue"? What will your life be like? Tell me more about this new reality and what it FEELS like.
Your answer
On a scale from 1-10, how ready and willing are you to invest in your family and having this aligned support?
Not at all (I am a clear NO)
1
2
3
4
5
6
7
8
9
10
SO READY, so willing and YES YES YES...where do we sign up!?!
Clear selection
Do you have the finances to invest in a coaching program at $7000 CAD or more?
Yes
No
No but I am open to being resourceful and findng a payment plan that aligns for our program/family's needs and current situation.
Clear selection
Do you have any questions before connecting with Amanda or anything you want her to know?
Your answer
Next step: If your commitment to your own personal growth is an "8 or more", click the link below so we can speak MORE! Thank YOU for showing up for you, knowing you are worthy of more and taking your time to set these intentions! I am SO happy you did!! Now book that free 30 minute connection session where we can find out if working (and PLAYING) together is a good fit and what our next "aligned" action steps together are! This is your chance to ask questions and share (all feelings, dreams/desires and parts of you welcome!!!) Look forward to connecting soon! :)
https://www.mindbodysoulmiracles.com/book-complimentary-discovery-session
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
Forms
