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Rebecca Regnier 1:1 Coaching Application
This application will take approximately 30 minutes to complete. Thank you for your thoughtful, honest and vulnerable answers as they will help us get right to work in accomplishing your GOAL!
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Email
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Your email
Name
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Your answer
City and Country
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Your answer
Phone Number
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Your answer
What is your current profession? Please share your LinkedIn Profile
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Your answer
Have you worked with a coach in the past?
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Yes
No
If Yes, when and for long did you work with your coach? What was your experience?
Your answer
What is the primary goal you want to accomplish by working with a coach?
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Your answer
What challenges have you faced that have stopped you from accomplishing this goal?
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Your answer
Imagine it is 1 year from today. What will your life look like if you have accomplished your goal? Be as detailed as possible as you imagine every area of your life (ie career, finances, relationships, health, spirituality).
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Your answer
What will your life look like if you have NOT accomplished your goal and another year has gone by? Be as detailed as possible.
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Your answer
On a scale of 1-5 (5 being highest), how committed are you to achieving this goal in the next year?
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1
2
3
4
5
Again imagining you have accomplished your goal with the support of powerful coaching. What would that be worth to you in monetary value?
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5,000 USD
10,000 USD
20,000 USD
Priceless
Is there any other relevant information you'd like to share with Rebecca?
Your answer
A copy of your responses will be emailed to the address you provided.
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