Karen Dubi
1:1 Coaching / Mentorship Application
First & Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
Phone Number
-
Area Code
Phone Number
Instagram and/or Facebook handle?
What do you currently do for work/professional career?
Have you ever invested in 'personal growth & development'?
Have you ever worked 1:1 with a Life Coach or Business Mentor? If so, what was your experience?
What specifically is calling you to apply to work 1:1 mentorship/coaching with Karen?
Currently, what area in your life are you struggling with or feeling out of alignment??
Do you have any current support to help you through this ?
Why now? What is different for you now than in the past?
On a scale 1-5, how ready are you to to embark on a journey of self mastery, growth and expansion?
1
2
3
4
5
Not feeling ready
I am all in!!
1 is Not feeling ready, 5 is I am all in!!
How willing are you to do what it takes to make this opportunity happen?
So ready!!!
Depends on the investment
I am not able to invest in my growth currently
What is the level at which you are ready to invest in yourself? Based on proximity, duration and self-paced or LIVE containers, there are different price points to suit your needs.
$5,000 - $10,000
$500 - $1,000
$1,000 - $5,000
Under $500
Complete this sentence:
One thing I can be excited about today is...
Complete this sentence:
If one word could describe the kind of person I want to be today, that word would be... and I chose this word because...
Is there anything else you would like to share or communicate with Karen at this time?
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