Scholarship Questionnaire

Conscious Coaching 90-Day Self-Mastery Scholarship

Please answer each question honestly and thoughfully.
Full Name

First NameLast Name
Email Address
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Phone Number
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Age
Instagram Username
City and State

Street Address

Street Address Line 2
Postal / Zip CodeCityState / Province
What is happening in your life right now that made you apply for this scholarship?
If you could change one area of your life right now over the next 90 days, what would it be and why?
What patterns, beliefs, or circumstances do you feel are currently keeping you stuck?
What is something about yourself that you have recently become aware of?
When you feel overwhelmed, triggered, uncertain, or uncomfortable, how do you typically respond?
Imagine it is 90 days from today and you feel genuinely proud about the progress you've made. What would be different about your life?
How would you like to feel mentally and emotionally at the end of these 90 days?
What would greater self-trust look like in your everyday life?
What is one decision, conversation, boundary, or change you know you may need to make but have been avoiding?
Why do you believe now is the right time for you to receive coaching?
What are you willing to do differently over the next 90 days to create a different result?
Coaching may require you to question familiar beliefs, recognize uncomfortable patterns, and take action outside of sessions. How willing are you to do that?
How willing are you to receive honest feedback and consider perspectives that may challenge the way you currently see a situation?
What does accountability mean to you?
Tell me about a time when you committed to something difficult and followed through. What helped you stay committed?
Are you willing to complete reflection exercises, practices, or assignments between sessions when provided?
If selected, is there anything that could realistically prevent you from completing the full 90-day program? If yes, please explain.
If yes, please explain.
Why should YOU receive the 90-Day Self-Mastery Scholarship?
Please don't tell me why you deserve it more than another applicant. Tell me why you're ready to use this opportunity.
Acknowledgment
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Acknowledgment
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Date

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Conscious Coaching 90-Day Self-Mastery Scholarship