3 Month Coaching Interest Form

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WHO THIS IS FOR: People who want to rebuild and reclaim their lives: self-love/care, marriage, motherhood, & business

STARTING DATE: Coaching Begins January 15, 2020

DETAILS: Weekly Zoom calls. Coaching on challenges, identifying goals, creating new habits and strategies to success, and meeting goals. 1:1 Coaching, Group Coaching, and E-Coaching (Electronic Coaching)

Coaching starting January 2020! I will help you transform yourself, your relationships, and your life!

1. Get clear on relationship goals, life goals, and what's keeping you stuck in or out of relationships!
2. Uncover what's causing you to lose hope, motivation, and drive in your relationship and your life!
3. Create a healthy you and healthy relationships that support your desires and passions!
4. Rejuvenate and recharge yourself, get that energy to have fun, love, and live the life you've been wanting.

This will be 12 weeks of transforming yourself and your relationships. Weekly assignments will keep you on track to reach your goals, along with weekly accountability to ensure you're operating at your highest level. Each week I will walk you through strategies to restore yourself and your relationships.

Taking applications. Enrollment Closes December 31, 2019! Limited Space Available!

Email *

Name *

Phone *

Relationship Status *

What is going really well in your life right now? *

What are the challenges in life? *

What do you want to change, reclaim, or rebuild in your life? *

Are you ready and committed to having lasting change in your life? *

Yes

Not Sure

Required

What type of coaching do you prefer? *

1:1 Coaching

Group Coaching

Video Zoom

Private Facebook Group Lives

Regular Phone or Conference Call

E-Coaching: Email, Text, and Voice Messages (Reduced Pricing)

Required

If Yes, will you be paying the SPECIAL monthly or full price? *

Group Coaching Monthly Payments of $54 (Paid on the 15th for 3 months)

Group Coaching Full Price $599 and save $50 (Paid prior to starting)

1:1 Coaching $125 per session

1:1 Coaching Full Price $1,200 (Special for 12 Sessions)

Interested In Email/Text/Voice Messaging Coaching Services (Prices Will Be Emailed)

Other:

Required

Are you able to invest in this 3 month coaching program and pay monthly payments or full price? *

Yes

Not At This Time

Possibly

Are you willing to give a review or testimonial for the program?

Yes

Clear selection

What do you want to have accomplished by the end of this Coaching Program? *

Thank You For Your Interest!

Your submission will be reviewed and I will reach out to you shortly. If you have any questions in the meantime, feel free to email me at kari@passion4visions.com.

Send me a copy of my responses.

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