Level Up in Life and Get a Coach!
Take control of your own journey and long-term growth! PIC supports under-resourced adults through one-to-one life coach partnerships. 

PIC welcomes applicants with household incomes less than $50,000 and holding no more than a bachelor's degree.

PIC life coaching is:

- Weekly 30-45 minute virtual conversations with your trained volunteer coach

- 1 year commitment to your partnership

-  No-cost coaching for one year ($5,000 value)

- Support as YOU create your path to get where you want to be in life!

Complete this form to learn more about receiving a PIC life coach!
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Email *
Watch this 30-second video for additional information about our program.
How did you learn about PIC Coaching (choose all that apply)? *
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First Name *
Nickname/Preferred Name *
Last Name *
Phone *
The combined total income for my household is: *
What is your highest level of education? *
Your current Zip Code? (At this time, Partners in Change only accepts individuals residing in the metro Atlanta area) *
Is there a goal in your life that you're ready to work towards? *
Can you commit to talking weekly for one year with a free volunteer coach? *
I want to attend a short Membership Orientation to find out more about receiving a Partners in Change coach and signing up! *
A copy of your responses will be emailed to the address you provided.
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