Coaching Application Form

Name

Email Address

What Are You Applying For? What Are You Applying For? Coaching For Women (Liberated Woman) Coaching For Men Coaching For Couples (Liberated Couple)

Describe your current relationship? Are you single or partnered?

Are you looking for ways to improve your relationship with yourself and/or with your partner?

What is stopping you from fulfilling this desire?

What are you struggling with most? How does this challenge impact your life, your confidence, your energy levels, and your relationships?

If you could change one thing what would that be?

If you could have your ideal love life what would that look like? What would your connection be like with your partner? How would you feel? What would be different?

How committed are you to making this vision a reality on a scale of 1-10 with 1 equaling not committed at all and 10 meaning that you’re 100% in.

What would it take to make this a 10?