Private Mentorship Application

PRIVATE MENTORSHIP APPLICATION
This mentorship is a space for high-achievers, leaders, and professionals who are ready to move beyond burnout and into alignment with their soul’s deeper purpose.

To make sure this container is the right fit, please take a few moments to reflect and answer honestly. There are no “right” answers here—just what’s true for you.
CONTACT INFORMATIONS
Full Name*

First NameLast Name
Email*
example@example.com
Location and Timezone*
e.g. New York, USA — Eastern Time (GMT-5)

ABOUT YOU
What’s your current profession or role? (Share what you do day-to-day, whether that’s your career, business, or main responsibility.)
How would you describe this current season of your life? (A few sentences—what feels present for you right now?)
Have you worked with a coach, therapist, or mentor before?

Yes, currentlyYes, in the pastNo, this would be my first time

WHAT YOU'RE EXPERIENCING
Which of these feel most true for you right now? (check all that apply)

My mind rarely slows down - I'm replaying, overthinking, or planning constantlyI feel exhausted but guilty when I restI've achieved milestone but still feel a lingering emptinessI second-guess myself and struggle to trust my decisionsI feel disconnected in my relationship or avoid conflictMy value feels tied to what I do or how much I makeI carry a lot of responsibility and it feels heavyOld wounds or emotions keep resurfacing
What are the main symptoms or patterns you notice in your daily life that are telling you something has to change?

YOUR READINESS
What inner work or personal growth have you already done? (Books, therapy, coaching, somatic/healing practices, spiritual exploration, etc.)
What feels most important for you to shift or heal right now?
Why do you feel called to mentorship at this time, instead of just a single session or shorter support?
What would you love to be able to say about yourself and your life 6 months from now?

ALIGNMENT
Mentorship is a committed container. Are you ready to invest your time, energy, and resources into this process?

Yes, I'm readyI'm unsure and would you like to exploreNot right now
Is there anything else you'd like me to know before we connect?
Submit your application and I'll be in touch soon. If it feels aligned, we'll set up a call to explore if this mentorship is the right fit for you.
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PRIVATE MENTORSHIP APPLICATION