Request for Professional Life Coaching Services

Raising Esther

Home of the Favored. Approved. Chosen. Queens. (FACQs)
NEW CLIENT QUESTIONNAIRE (Schools & Non-Profits)

Thank you for your interest. Please complete this form so that I can better serve you.
Part I: General Information
Name of Organization *
Primary Contact *

First Name Last Name
Title *
Phone Number *

Area Code Phone Number
E-mail *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Organization's Website URL (if applicable)
Part II: Background and Needs Assessment
What category are you most interested in? *

Confidence coaching Identity/Self-Image Victory over Self-Sabotage Finding Purpose Goal-setting Relationships Thriving through separation/divorce Parent Coaching How to become a Girl Coach
What kind of service would you like Coach Q to provide? *

One-on-one coaching Group coaching Speaking Engagement Training/Course Workshop Periodic Check-ins and Encouragement
Which of the following courses would greatly benefit those within/ connected to your organization? *

How to Effectively Lead and Connect with God's Girls (8 weeks - Parent and Teacher versions available, Zoom or in-person options available) Biblical Strategies for Coaching Adolescent Girls (6 weeks) Royal Mindsets (4 weeks of mindfulness and mindset coaching) None
Which category best describes your target audience? *

Middle School Girls Middle School Teachers High School Girls High School Teachers Parents/ Guardians
Are you more interested in virtual, in-person, or hybrid options for coaching and training purposes? *

Virtual only In-person only A combination of both
Approximately how many people will be attending the session? *
What is the top goal you would like to be accomplished upon completion of services? *
Part III: Your Investment

The investment you make today can have a priceless, intangible, positive impact in tomorrow's outcomes.
Are you prepared to invest financially in the mental, spiritual and emotional well-being of adolescent girls? *

Yes No
What is your estimated budget?
Anything else we can help you with?
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Raising Esther

NEW CLIENT QUESTIONNAIRE (Schools & Non-Profits)

Part I: General Information

Part II: Background and Needs Assessment

Part III: Your Investment