Apply for VIP Day Coaching with Jessica

1
What is your full name?* This field is required.
First Name
Last Name
2
What's your best email so we can send your acceptance letter?* This field is required.
example@example.com
3
What's your best telephone number if Jessica needs to reach you?* This field is required.
Area Code
Phone Number
4
How did you find out about Jessica? If someone referred you, please let us know.* This field is required.
5
Tell us what inspired you to want to work with Jessica.* This field is required.
6
Thanks for that. So _____, what is your 2 biggest challenge with hitting your goals or up-leveling in a specific area of your life or business?* This field is required.
I have lots of ideas and sometimes struggle on my own to stay focused.
I'm the most motivated in my circle, so no-one really holds me accountable or sets the bar higher.
I know I have it inside me, but I often suffer from Imposter syndrome and worry that I'll never fulfill my greatest potential and make the difference that I want to make.
I'm constantly busy and find myself burnt out or overwhelmed.
I'm a workaholic and so my health or personal relationships suffer.
I don't have the right kind of support.
I struggle financially
I don't have a clear purpose or vision for my life or business
7
What worries you the most right now?* This field is required.Check all that apply
That I'm running out of time to achieve what I want
I have a lot of ideas, but I don't know where to start or I get distracted
That I'll have to sacrifice a lot to accomplish the big goals I have
What people will think of me when I make myself visible or pursue my dreams
That my bad habits will sabotage my success
That I don't have the right support
My current health
My financial situation
Other
8
What about working with Jessica is most exciting for you personally?* This field is required.Check all that apply
I thrive with lots of accountability, and this is perfect for me
Learning from her because she's had twenty years of experience as a coach and 4x business owner
I'm excited to learn and implement Jessica's performance & productivity tools
Learning and developing Jessica's pro mindset method
I can't wait to ask Jessica questions and get feedback on what I'm doing in my business
Getting clarity on my purpose so I can turn it into a mission that helps others
Having a specific plan to execute
All of the above
Other
9
Just so we know, which of the following best describes your current status?* This field is required.
New business owner just getting started
Experienced business owner struggling to sustain or grow
Aspiring business owner
Job that I love. I'm here for the personal growth!
Other
10
What is your current annual revenue?* This field is required.This is private and will not be shared with anyone.
$0 - 50,000
$75,000 - $100,000
$50,000 - $75,000
$100,000 - $200,000
$200,000 +
11
Rank/Rate the following items listed below in order of importance to you right now* This field is required.Drag each item to arrange them in order from 1 = Most Important to 6 = Least Important)
12
Which of the following VIP opportunities are you applying for?* This field is required.
A 3 - 5 hour VIP Day Strategy Session, with unlimited text & audio coaching for 15 days to implement my plan
30 Days of 1:1 coaching with Jessica. Includes a 3-hour VIP day, 2 coaching calls, and unlimited text & audio coaching to implement my plan
I'm not sure. I'd like to discuss with Jessica to determine the best fit.
13
If selected, I commit to showing up on time to all my sessions/trainings, doing the homework, and actively participating in the program to make my experience a success.* This field is required.
Yes, I’ll do it twice if needed I'm a hard worker!
Can't lie, I'm not going to do it
14
Almost done! We want to make sure you are serious about working with us! Jessica only accepts 1:1 clients who are committed to their personal & professional growth, who value excellence, and who are ready to apply what they learn and take personal responsibility for their results. Does this sound like you? Why or why not?* This field is required.Almost done!
Huge
Large
Normal
Small
Ok
Ok
15
I understand the minimum investment to work with Jessica is $5,000. I am ready to make that commitment to my life today so I can learn all Jessica has to teach me. * This field is required.
I’m ready, It's my time, continue my application.
I’m not there yet, but please check back in with me next year.
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