1:1 Mentorship Application Form
This is an intimate space. Your answers help me understand where you're at, what you’re ready for, and how I can best support you. Be honest, there are no wrong answers here.
Full Name
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First Name
Last Name
E-mail
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example@example.com
How did you hear about me?
What’s calling you to work with me right now? (What made you enquire? What’s stirred something in you?)
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Where are you at in your personal journey?(Share what’s been present for you mentally, emotionally, physically, spiritually.)
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What’s no longer working for you?(What patterns, beliefs, habits or experiences feel heavy, limiting, or done?)
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What do you actually want instead?(Be specific - clarity, confidence, safety in your identity, deeper connection, etc.)
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What have you tried already to shift this?(What’s worked, what hasn’t, and what’s still missing?)
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What would transformation look like for you over the next 3–6 months?(Describe the version of you you want to rise into.)
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Where do you feel the most blocked or stuck right now?(Mind, body, emotions, identity, relationships, career, etc.)
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Do you resonate with a holistic approach?(I use a blend of somatic work, breath, mindset, energy, and identity-based practices. Are you open to this?)
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How committed are you to doing the work and showing up for yourself?(1–10, and be real about it.)
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Are you open to being challenged with love, called forward, and held accountable?(This is a co-creation, not hand-holding.)
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Is there anything else I should know about you or your journey?(Share anything that feels relevant or important.)
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Do you have the capacity to invest time, energy, and finances into this mentorship?(This doesn’t need to be a yes. I just want honesty here.)
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Submit
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