"Inner Leader" Application Questionnaire

"Inner Leader" Application Questionnaire

Thank you for taking the time to fill out this survey. Please note: submitting this survey does not guarantee your place in the program.
Name of the Individual
1. Do you identify as female?

YesNo
2. What are the areas/issues you'd like to work on?

Impostor ComplexBlocks to career advancementConflict with coworkers/familyPerfectionism"Please disease"/need to please othersInability to set or keep boundariesLack of ConfidenceIssues with Presence (voice, pace, posture)Other (explain)___________________________________
3. Have you ever worked with any of the following?

Leadership CoachOther Coach (life, business, etc)Energy HealerGuru/Spiritual AdvisorOther
4. Rate your life satisfaction currently, from 1-10.
5. What self help, business, or other non fiction book do you recommend to others?
6. How would you describe your current work environment? (optional)
7. Do you consider yourself Left Brain (logical, analytical, orderly) or Right Brain (creative, emotional intuitive)?

Left BrainRight BrainNot sure
8. On the "fixed mindset" to "growth mindset" scale, where do you see yourself?
9. How authentic do you feel in your personal life?
10. How authentic do you feel in your professional life?
11. How do you feel about meditation/mindfulness?

I love it! I do it all the time.I like the idea, I just don't know if it's for me.Dislike it. Would never try it.Other
What are three main goals you have for your life and work over the next 2-5 years?
5. Additional Notes
Thank you for taking the time to fill out this questionnaire. It will be kept in the strictest of confidence and deleted after review. Elissa will reach out with any follow up questions.
Should be Empty: