Question Title * 1. Full Name Question Title * 2. What is your email address? Question Title * 3. Phone Question Title * 4. LinkedIn URL Question Title * 5. Have you ever participated in a coaching or mentoring program before? Yes No If Yes - Please provide details of your coaching relationship. Question Title * 6. What is the highest level of school that you have completed? Some high school, but no diploma High school diploma (or GED) Some college, but no degree 2-year college degree 4-year college degree Graduate-level degree None of the above Question Title * 7. What are your primary career or professional development goals for the next 12 months? Choose your top 3. Advancing in my current job or career Transition to a new career or industry Enhancing leadership and management skills Improving work-life balance Building better communication and interpersonal skills Increase confidence and self-esteem Enhancing management and productivity Achieving specific personal or health-related goals Pursuing entrepreneurship or business growth Strength relationships and personal connections Navigating a major life change or transition Other (please specify) Question Title * 8. On a Scale, how committed are you to achieving your goals through a 12-month coaching program? Not Committed Somewhat Committed Very Committed Question Title * 9. Are you willing to invest the necessary time and effort to work on your goals consistently throughout the 12-month program? Yes No Question Title * 10. What is your preferred communication style for coaching sessions? (e.g., in-person, video calls, phone calls, or email) Video Calls Phone Call In Person Question Title * 11. What is your budget for investing in coaching services? (Committed to a minimum of 12 sessions within a year. $50-75/Session $75-100/Session $100-125/Session $125-150/Session Question Title * 12. Are there any specific concerns or limitations that might affect your participation in a 12-month coaching program? (e.g., time constraints, financial limitations, or other commitments) Time Constraints Financial Limitations Other (please specify) Question Title * 13. How would you describe your current support system for achieving your goals, such as friends, family, or colleagues? Submit Application
