Application- From Anxious to Achieving 
Thank you for taking the time to fill out this application. We look forward to working with you and your teenager to achieve their goals and aspirations. This is the first step, after you fill this out, we will contact you for a phone conversation. 
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Email *
Your Full Name:
Teenager's Full Name:
Teenager's Age:
Your Contact Email:
Your Contact Phone Number:


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Briefly describe your teenager's personality and interests:


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What are your teenager's strengths and weaknesses?
Are there any specific challenges or issues your teenager is facing currently?


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What are your main goals for your teenager in participating in this mentorship/life coaching work?


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What changes or improvements would you like to see in your teenager's life as a result of working together?
How do you envision your child benefiting from this work? 

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Is there any other information you believe is important for the life coach to know about your teenager or your family?

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Are there any specific areas where you would like to be more involved or have input?

I am prepared to give  consent for my teenager, to participate in mentorship and life coaching sessions. I understand that the information provided in this application will be used to tailor the coaching experience to my teenager's needs.


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