Executive Platinum 1:1 Coaching Program Application
Cell or Office Phone Number
What made you decide to apply for the Executive Platinum Coaching Program?
Are you still in corporate at this time? If so, what is your transition plan (if you have one)?
Have you left corporate? If so, what stage is your business at? (For example, I'm just starting out. I have landed my first corporate clients.)
What are your goals over the next 12 months for your consulting or coaching business in terms of contracts landed and target revenues?
What is the Number 1 challenge or issue that is currently preventing you from gaining the traction you want to see in your business?
What results would you like to see from working together?
Are you committed to carrying out tasks involved (time-wise and action-wise) as a participant in this program in order to get results you want to achieve?
If you have a website, please provide URL.
Were you referred to this program by someone you know? If so, please provide their name.
What else would you like me to know about you?
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