Application for "Dream Achievers Coaching Program" 2026
The information provided here are confidential and are for the purpose of candidate selection only.
Full Name
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First Name
Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal Code or Zip Code
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Country
Email
example@example.com
Cell Phone Number
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Format: 00 (000) 000-0000.
WhatsApp Number
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Format: 00 (000) 000-0000.
Are you between 18-35 years old?
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What is your birthday?
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1. How did you hear about us?
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2. Hypnosis and NLP will be used to help change unwanted habits and subconscious programming for success. Do you consent to being hypnotized for the purpose of your personal growth and success?
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3. Have you been diagnosed with or experienced any of the following: Schizophrenia, multiple personality disorder, epilepsy? If yes, please explain.
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4. Are you currently enrolled in a full time educational program (college, trade school)?
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Yes
No
5. If you answered YES to question #4, please write down the name of the school, your major and your graduation date?
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6. Have you worked with a success or life coach before, either one-on-one or in a group setting? How was your experience?
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7. Why do you want to participate in the Dream Achievers Coaching Program?
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8. What kind of support do you need to help you achieve your goal? Be as specific as possible, ie, motivation, remove fears, wake up early.
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9. Do you have a specific goal you want to achieve?
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Yes
No
Maybe
10. What is the specific goal you want to achieve?
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11. What would it mean to you if you achieve it? How would your life be different?
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12. Participating in the Coaching Program requires you to be coachable, open-minded, willing to learn and willing to work hard to achieve your goal. Are you willing to do that?
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13. The Coaching Program also requires you to attend at minimum of 8 out of 12 group sessions and make up for missed sessions. Are you committed to do that?
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14. How committed are you to doing the work required to achieve your goal during this program?
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I’m all in
I want to, but I might need help
I’m interested, but not quite ready
I’m just curious
15. When we embark on a goal that is important and worthwhile, challenging obstacles may show up. At times like this, it may be tempting to quit the program and your goal. Will you promise to ask for help and not quit until you have exhausted all solutions? We want everyone to succeed and cross the finish line together as a group.
16. Is there anything that would prevent you from attending the required sessions or participating fully in the Coaching Program?
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17. What would success in this program look like for you?
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18A. Do you currently use or struggle with any substance use or addiction? (Confidential)
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Yes
No
Maybe
18B. If you answered Yes or Maybe to Question 17A, please explain here
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19. Is there anything else you’d like Prema to know about you?
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I declare that everything I shared on this application is true and that I have read and met the requirements for the Coaching Program.
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YES
Signature
Date
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Month
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Day
Year
Date
Please verify that you are human
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SUBMIT APPLICATION
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