Strategy Session Registration Form

Thanks for your interest in the Pivot with Purpose Program. Please answer the questions below. I'll be in touch shortly to provide schedule a complimentary 30-minute Career Clarity Session to see how we vibe and better understand your goals.

Pivot with Purpose is a 12-week online coaching program that includes: 3 individual coaching sessions and 9 professional development modules. An Internet connection is required for video conferencing (Zoom), email and web-based access to course content.

The investment for Pivot with Purpose is $997 - a payment plan is available. Registrants paying in full upfront will receive an additional 1-on-1 coaching session ($250 value).

Name

First NameLast Name

E-mail

Address

Street Address

Street Address Line 2

State / Province

Country

How committed are you to make a change at work?

	1	2	3	4	5	6	7	8	9	10

1 is Not at all, 10 is Fully Committed

What are your 3 most important career goals for the year ahead?

How would your life change if you could achieve the goals listed above?

What's holding you back from making progress?

Why do you want to work with me in the Pivot with Purpose Program?

Which statement(s) best describes your current situation? (Choose up to 3)

Other

I understand that the investment for 'Pivot with Purpose' is $997 for 12 weeks (this is an acknowledgment, not a commitment).

Would you like to join the 'Engineer Your Bliss' community and receive periodic updates via email?

Application: Pivot with Purpose Program