Private Coaching Application

Name

First and last

Email address

Street address

We love to send surprise gifts!

Street address line 2

City

State

Zip code

Phone number

Include area code

Best time to call is

Include Time Zone

Birth date

Date

Gender

Have you invested in a coach before?

YesNo

If yes, what was your experience like with the coach? What would you like to get out of this coaching experience? If no, what would you like to get out of this coaching experience?

Notes about individual coaching privileges:
Our clients get full access (within reason) to Jessica via Direct message, Voxer, and Facebook messenger for the duration of the 90 days in addition to the weekly one-on-one call. This includes access to the private client-only Facebook page where you can get encouragement, ask questions, share inspiration, your wins, additional resources, action steps, and accountability with other like-minded creative entrepreneurs.

What is your vision of your best self? How would your life be different if you stepped into being that person?

What is working well in your life right now?

What do you want more of?

What are three primary things you MOST WANT to create/experience?

On a scale from 1-5, how ready are you to invest in changing your life with an unstoppable mindset?

	1	2	3	4	5

1 is Worst, 5 is Best

Why is now the right time for coaching with Jessica?

What is one of your greatest struggles? Something that you’ve worked on addressing but it keeps throwing you off?

What do you hope to accomplish through coaching with Jessica?

How did you hear about this program?

Instagram/Facebook StoryFacebook GroupEmailOther

Are you a Creative Entrepreneur Society Member?

YesNoI want to hear moreOther

Duration of program

The program is 12 weeks long.

Can you commit to a 50 minute meeting each week for 12 weeks?

YesNo

Application Review

Applications will be reviewed from when received. Qualified applicants will receive a call from a team member to ask a few more questions.

Payment details

Introductory rate: $2,000.00.

Payment is due before the first call with Jessica, by credit card. A payment plan is available.

Note that more than 12 participants will receive an acceptance email, but only the first 12 to submit payment will be enrolled. The remaining will be placed on our waiting list for the next available opening.

Much Love,

Jessica Laughlin