Applicant's Information Coaching with Dirk Stroda

Applicant's Information Coaching with Dirk Stroda

Please fill out the Questionnaire form below. Thank you!
Your Name

First Name Last Name
Company Name (if applicable)
Date of Birth

Month Day Year
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Your E-mail
Your Address

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Your Cell (Mobile) Number

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I. LOOKING BACK: Please disclose details of your past; how you got there where you are today (professional and personal life). List all relevant accomplishments and challenges that you have mastered in the past and goals that you have achieved.
II. DESCRIBING: Describe your status-quo (what is your current situation) and list the threads and immediate needs to find a solution to your challenges. What stresses you the most?
III. LOOKING FORWARD: Assuming that all problems have been resolved. What would you do next?
Give additional comments which you believe will be important for the success of your coaching (optional):
All information provided will be handled stricktly confidential. Please understand that this coaching program is not of therapeutical nature. This coaching program does not dispense medical advise. The intent of this coaching program is to offer information to help you in your quest for emotional and spiritual well-being. Your coach assumes no responsibility for your actions.

We will respond to your application within 2-4 business days.
Your preferred way to communicate one-on-one with Dirk Stroda:

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Name of Patents or Guardian in case of Minor Applicants (under the age of 18)

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