1:1 Mentoring Program Intake Form

1:1 Tailored Mentoring Program Intake Form
Welcome, Sister.

You are here because you are ready to say YES to more ease, flow, confidence from within and living in synchronicity with your natural cycles, body, needs and inner knowing to invite abundance, success, joy and happiness into your life! You are ready to expand and crack right open. This is an invitation to join me in partnership for six months (timeframe sliding scale 3-12 mths depening on your needs) of immersive, transformational guidance in reclaiming your power and wisdom from within, become your own healer and leader and leading a thriving, authentically empowered life, holistically and sustainably. I work with women who are ready to take responsibility for their lives, go deep, and work to become their highest, most authentic and aligned self, ready to commit to and show up for themselves with inspired action; ready to face the mud to flower as a beautiful, pure lotus; ready to drag their shadows into the light. Please note that 1:1 mentoring is a significant investment in your transformation and expansion of self, and your life in response to it. If your application is accepted, you will be invited to have a compatibility call with me, where we will get clear on where you are at and your goals and feel into if we are a match and ready to kindle your magic and empowerment together. Working one-on-one is intense and both of our time energy is valuable. Therefore, please do not apply if you are not ready to begin work straight away or if you are not yet feeling ready to actually implement and follow through on change in your life. If we are an aligned match you will hear back from me very soon! I am looking forward to getting to know you and feel honoured for you to be here. From my heart to yours, Lena x
Name *

First Name Last Name
Email *
example@example.com
Date of Birth *

Month Day Year
Date
What's your Instagram handle if you have one?
Phone Number
Please enter a valid phone number.
Where do you live and what’s your time zone? *
Have we met or worked together in any capacity before? *
So, tell me more about you. Who are you, and what are you passionate about? *
What are you looking for coaching on? *

Deepening the relationship to my body & self strengthening my intuition / self-empowerment living in my flow state moving closer towards fulfilment and my dharma (purpose) healing past trauma and leaning IN to life healing and balancing my physical body / resolving (chronic) dis-ease and symptoms holistically / finding answers for health conditions living healthier and more aligned in general improving my mental health / state / outlook on life manage and heal my emotions conscious relationship to myself /others/life transmuting my shadows & elevating my overall frequency changing old habits/patterns/belief systems that don't serve me anymore embarking deeper my spiritual path / self-development and healing Other* (explain below)
*Other:
Tell me about what your life feels like for you currently. What are frequent emotions that are coming up for you day to day, how are you feeling in your own body & skin, emotionally and mentally; in your environment or current circumstances? What current struggles are you experiencing? Be as honest as you possibly can. *
What do you deeply desire right now, more than anything? *
What's your dream future scenario, 6 months from us working together? Describe it as best you can. *
On a scale of 1-10, how ready are you to start making thisdream scenario a reality? *
Have you worked with a coach or mentor before? If so, whatwas your experience like, and who was it with? Please also include any coursesyou've taken, or counselling or therapy you've had. *
What makes you think I'm the right coach to support you inachieving your goals right now? *
Please only continue if you are committed to taking yourholistic wellbeing, confidence and empowerment from within to the next level,and are ready to get to work straight away.

If your application is successful,you will be booked in to have a compatibility call with me directly. We willget clear on your goals and how we can achieve them together. Lena has a very limited number of spots available forprivate coaching. The investment to work privately on your self-empowerment,expansion and wellbeing over 6 months is AUD$2500. Monthly payment plans areavailable on request as well as varying program packages (3-12mths /$1500-2500)
Which is most true for you right now? *

I have the time, energy and resources to make this commitment to myself, and I am READY for this next chapter of my life! I have access to (or am willing to find) the financial resources to make this investment in myself. I know it will be truly worth it and I will make it happen! I do not have the resources to make this happen, but would like to be informed of lower investment options for group coaching instead, so I can work with Lena in a different way.
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