1:1 Coaching Application

1
Name* This field is required.
2
Your pronouns* This field is required.
3
Your email (be sure to double check spelling)* This field is required.
example@example.com
4
What is the current state of your relationships and your sex life?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
5
What are you currently doing in terms of self-love? What do you practice? What is integrated into your routines?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
6
Tell me about your self development journey. What kind of professionals have you worked with and what kind of modalities have you been exposed to? Please also be sure to let me know if you’ve worked with a 1:1 coaching for before and if you’ve ever been in therapy.* This field is required.
Huge
Large
Normal
Small
Ok
Ok
7
What do you desire to receive in working with a coach?* This field is required.Tell me everything, don’t hold back
Huge
Large
Normal
Small
Ok
Ok
8
What is your availability and time zone? When are you looking to start?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
9
Are you applying for sliding scale? If so, why are you requesting accommodation?This coaching journey and ceremony is intended to be a serious investment, we use sliding scale pricing to create equity. There are 2 sliding scale spots available on a first-come-first-served basis. When you apply for sliding scale, remember you’re taking a spot from someone else who may be in need. Sliding scale operates on the honor system where people self-select as sliding scale recipients based on this graph: https://static1.squarespace.com/static/54a1bf90e4b07c077787ed68/t/55d650e6e4b0bb73fdc7b993/1440108774760/GreenBottleSlidingScale.png. People in dual income households or with the cost of coaching already in a savings account do not qualify.
Huge
Large
Normal
Small
Ok
Ok
10
By submitting this application, you are acknowledging that you understand there is a minimum $4,799 investment for coaching for 4 months ($2,599 for sliding scale).* This field is required.People who answer no are inelegible for coaching
YESNO
Should be Empty: