Private Coaching Application

Application

One-on-One Coaching

Welcome. Congratulations for taking the first step and deciding to apply for One-on-One Coaching with Renee. Before we commit to working together, I need to make sure that you're a good fit for the program. This is my chance to learn who you are, what you're looking for and what results you want to get. Please answer openly and honestly - all answers will be kept strictly confidential. Best, Renee

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- By checking this box, I agree to answer each question below honestly and to the best of my knowledge. I also understand that filling out this application does not entitle me to a coaching spot with Renee, nor does it constitute a commitment to make any investment. I understand that this application shows my interest in Private Coaching and that I am ready to consider investing in myself and my health.
Name*
First Last
Email*
Why do you think you'd be a good fit for one-on-one coaching with Renee?*
What is the HUGE breakthrough you'd like to create? If we could "wave a magic wand," describe specifically what this experience would create for you:*
What challenges have you been dealing with? (check all that apply)*
- I feel like something is missing
- I want to change my life
- My relationship is on the rocks
- I cannot stand my body right now
- I think I may have unconscious limiting beliefs
- I lack confidence in moving ahead
- I feel overwhelmed with certain areas in my life
- I feel unhealthy with my eating and drinking habtis
- I lack self esteem
- I am so hard on myself
- None of these really apply to me
Describe any other challenges or limits you're experiencing. What should I know before we talk?*
Do you have a history of working on yourself? What other investments, if any, have you made in yourself in the last 1-2 years?*
Which is true for you?*
- I am completely COMMITTED to creating a massive breakthrough in my life and my results
- I just want more information about how you are creating so much success, but I am not sure how committed I am to seeing similar results in my life
- I consistently look for what others are doing with no intention of ever taking action. My life and success are pretty good right now, thank you
How soon are you looking to get started?*
- RIGHT NOW!!
- I already know it's going to be a few months before I can commit the time
- I'm not sure this is even for me, but I'm going to keep researching
We find our most successful students have an income to support themselves while going through this process. What is your current income situation? (Annually)*
- < $50,000
- $50,000-$100,000
- $100,000-$200,000
- $200,000-$500,000
- > $500,000
Which Best Describes You?*
- I have financial resources to invest in coaching right now. I know mentoring with Renee isn't cheap, but it's worth it to create the life, growth and success I want
- To be honest, no matter the success you could create with me, I am not sure I have the finances to do anything right now. Maybe you could help me figure out how to make it happen.
- I don't even have two spare pennies to rub together right now
Who/what most influenced your decision to reach out to Renee?*
- Yes! If I qualify, I want to speak with Renee about One-On-One Coaching as soon as possible
What is the best phone number to reach you?

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