Apply now to see if you qualify for your "1 Conversation Away" FREE Clarity Session with Polish Peter.
Please answer all questions below. Make sure your email/contact info is correct as that's where you'll get access info for the FREE zoom video coaching session with Polish Peter. Please note that filling out the form does not guarantee you a spot for the free session. The free session will be given based on the availability.
Your Name
*
First Name
Last Name
Your best email address (for contact in regards to the free session)
*
Phone Number (if you'd like to be texted with info for the session)
Please enter a valid phone number.
Format: (000) 000-0000.
How did you learn about the 1 Conversation Away clarity session?
*
Do you have a business?
*
Yes
No
What kind of business is it? What do you do? (if you don't have a business, do you want to have one? if not, just say: "I don't have a business")
*
If you have a business, what is your monthly revenue?
*
Less than $10,000
$10,000 - $100,000
$100,000 - $250,000
$250,000- $500,000
$1,000,000+
I don't have a business
Back
25% completed - next page...
Session Focus!
What is the #1 thing you want to get out of the session with Polish Peter?
*
How badly do you want to have this breakthrough, this change and/or problem solved?
*
It's a MUST
It's a should
It would be nice if it changed but...
Ehhh, I could take it or leave it
What do you think is the biggest roadblock stopping you from getting what you want?
*
In one word, what do you think is the biggest obstacle keeping you away from reaching your goals?
*
0/1
If you could wave a magic wand and have a genie grant you any wish, what would you want your life and/or business to look like (say in the next 12 months)?
*
0/1
Back
50% completed - next page...
Tell Me About Yourself!
Please evaluate honestly and use the first answer that comes to mind. BE YOU! Not how you want to be but how you are in life, right now!
*
Rows
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
I make decisions FAST
People Look up to me
I accept life as it comes
People say I have a strong personality
I need a lot of details before making a decision
I find it difficult to relax
I enjoy having fun
I tend to do what I am told
I like working by myself
I'm willing to try new things, take a risk
I believe things will go well
I am always willing to help
I generally get my own way
I tend to trust people
If I have to make a decision, I tend to take my time
I am self confident
I like things to be precise and correct
I persevere until I get what I want
I do not treat life too seriously
I am an agreeable type
I often come up with original ideas
I tend to be a cautious person
I am good at convincing people
I am always willing to follow orders
I am a very social sort of person
I don't like arguments
I tend to be very receptive to other people's ideas
I tend to be a forgiving type
I have a lot of energy and vigor
I enjoy chatting with people
I tend to keep my feelings to myself
Accuracy is very important to me
I like to speak my mind
I tend to be an aggressive type
I like to have fun and have a lot of personality
I am good at motivating people
I am careful to say the right thing
I get a lot of satisfaction from helping others
I think about how my decisions might affect others
I like being in the center of things, in crowd
I prefer to get things done now rather than later
Back
75% completed - next page...
Your Agreements in Order to Participate
Are you willing to be vulnerable with Peter on the call?
*
Yes
No
Are you willing to be coachable with Peter on the call? (Coachable means that you are open to hearing something new and the possibility that what Peter coaches you on is true.)
*
Yes
No
Free clarity sessions happen every Thursday at 1pm EST (unless rescheduled by Peter prior to the day). Are you able to make that time and be there LIVE, on time?
*
Yes
No
At the end of the free clarity session, I'm open to hearing about your coaching mastermind to determine whether or not this would be a great fit for me to help me on my journey.
*
Yes
No
Maybe, depending on what happens at the session.
I agree that I do not have any medical conditions that could harm me during and after the coaching session. I am not suicidal. I agree that coaching does not involve the diagnosis or treatment of mental disorders as defined by the American Psychiatric Association and that coaching is not to be used as a substitute for counseling, psychotherapy, psychoanalysis, mental health care, substance abuse treatment, or other professional advice by legal, medical or other qualified professionals and that it is the Client’s (my) exclusive responsibility to seek such independent professional guidance as needed.
*
I agree
I disagree
I agree that the free clarity session will be conducted via zoom VIDEO, which means I'll be on video with Polish Peter.
*
Yes
No
I am open to the session being recorded.
*
Yes
No
I agree that everything I said above is to my knowledge, 100% true.
*
I'm ready! Submit my FREE Clarity Session Application now...
Should be Empty: