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One-On-One Coaching Application
Please fill out this application if you're interested in becoming a one-on-one coaching client. I will reach out to you via email within 3 business days to schedule a free discovery call or to ask clarifying questions if needed.
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Email
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Your email
Today's Date
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Full Name and Pronouns
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Your answer
Date of Birth
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Cell Phone Number
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Your answer
Mailing Address
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Your answer
Tell me anything about you that you'd like me to know. This could include details about your employment, schooling, social circle (especially furry friends), hobbies, passions, etc.
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Your answer
What do you think your best qualities and abilities are? Where do you really shine?
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Your answer
What are your goals for one-on-one coaching? What do you hope to accomplish or set in motion over the next six months if we work together?
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Your answer
Why is increasing your sense of self-trust important to you and what do you think has held you back from developing a deeper sense of self-trust?
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Your answer
In what parts of your life do you find yourself experiencing the most self-doubt and shame?
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Your answer
Where would you say you are in your personal social justice and anti-oppression journey? Have you done much unpacking around power and privilege? Are there certain teachers you look to in this area?
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Your answer
Why are you interested in working with me and do you have any expectations for me as your coach that you'd like me to be aware of?
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Your answer
One-on-one coaching is $850/month for a six-month commitment. Is this an amount that you can fit into your budget and are willing to invest?
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Yes
No
If you have experienced trauma in the past and certain things I could do or say as a coach might be triggering for you as a result, you're welcome to use this space to give me some guidance and suggest any boundaries you'd like me to respect (trauma-related or otherwise).
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How did you find out about my coaching?
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Would you like to be added to my email newsletter list?
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I'm already on it
Anything else you'd like to share with me?
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Send me a copy of my responses.
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