What is your name? *

What is your email address? *

Would you prefer a SKYPE call or a Phonecall? *

What is your SKYPE ID or phone number? *

What are your top 3 goals in the next 3 months? *

What are the things causing you the most pain right now in your life? *

What actions have you taken so far to overcome these pains? *

Have you reached the point where you have said "I've Had It"? *

If yes, how do you know you have reached the "I've Had It" point? *

How much have you invested in yourself for Personal Development in the last 12 month financially? *

Through which channel were you attracted to me to apply for coaching? *

Finally, why do you think I can help make progress in your life? *

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