1:1 Application Form

1

What is your biggest challenge right now?* This field is required.If you have challenges with multiple, select the highest priority one.

Masculine & feminine energy balance

Setting boundaries & communication skills

Confidence & self-esteem

Connecting to my emotions

Intimacy & closeness with my partner

Something else

2

Have you worked with a coach or therapist before?* This field is required.

Yes, a coach

Yes, a therapist

Not yet

3

How committed are you to working on yourself to fully achieve success?* This field is required.No judgement here. Select your true commitment level even if you feel scared.

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2
3
4
5

I'm not ready yet

I'm fully committed

4

Do you currently have the funds to invest into coaching?* This field is required.Coaching is a powerful investment in yourself. To help us both know what’s possible, please share your current readiness to invest financially.

✅ I’m fully ready to invest in myself and my growth

I’m committed, and I’ll make the finances work if this is the right fit

I’m not in a financial position to invest right now

5

What is your age?* This field is required.

6

What is your occupation?* This field is required.eg. Software Developer, Marketing Manager, Entrepreneur, Sales Associate, etc...

7

What is your name?* This field is required.

First Name

Last Name

8

What is your Instagram username?

@username

9

What is your Instagram username?

@username

10

What is your email address?* This field is required.So we can schedule your free 60 minute Discovery Call.

example@example.com

11

Congrats! You qualify for the 1:1 Program: a personalized coaching experience containing weekly calls & guaranteed results with a four-figure investment. Next, book your 60 min Discovery Call with Kevin:You'll be able to schedule your free Discovery call on the next page.

I'm willing to invest in myself ✅

I need some more info before I'm ready

I'm not ready yet