New Life Blueprint Questionnaire

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1. First off, what's your full name?* This field is required.
First Name
Last Name
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2. What service are you interested in?* This field is required.
Group Coaching
Private Coaching
Strategy Intensive
Speaking
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3. What's your email address* This field is required.
example@example.com
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4. What's your contact no.?* This field is required.
Area Code
Phone Number
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5. What are your three biggest accomplishments to date? And why are you proud of them?* This field is required.
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6. Tell me about your business/career success over the past 10 years.* This field is required.(The impact you've had, the income you've created, and your clients' success stories)
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7. What are your 2 goals for the next 12 months and why?* This field is required.(1 business, 1 private)
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9. What’s missing from your work and/or professional life?* This field is required.
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10. The Extraordinary: If you were to look back 3 years from now, and say “Joining Camilla’s community was one of the best decisions in my life...” what has to have happened, personally and professionally, for you to feel thrilled with your progress?* This field is required.
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11. The Impossible: What would you like to accomplish that looks impossible but if it were achieved would change everything?* This field is required.
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12. The Upper Limit: If in 3 years’ time you are disappointed with your results, why will that be? eg. unhealthy relationships, poor habits, limiting beliefs, fear of success.* This field is required.
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How much are you willing to invest in yourself?
Please Select
Please Select
0 -$5,000
$5,000 - $10,000
$10,000 - $20,000
$20,000 - $30,000
+$30,000
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