Nurturing Through Mentoring!

Application for Coaching

Name *
Address *
City *
Province or State *
Postal Code *
E-mail Address: *
Day Phone *
The industry you work in is: *
In this industry, I have great passion for: *

You would like ________ Coaching: *
Your biggest challenge currently (and the reason you are seeking a Coach) is... *

Do you have a project you can apply what you learn to? If so, describe this project. *

3 goals you want to accomplish in my Coaching are: *

Have you had Coaching before? If so, describe your experience. *

There will be times when your Coach will ask you to work hard or put in extra time. How will you handle this request? *

How many years of experience do you have in this industry? List some of this experience (resume). *

Do you have a business? If so, describe its main purpose. *

You work with _____ staff or co-workers. *
My net income is: *
Are you willing to sign a waiver agreement before entering coaching? *
What is your biggest challenge as an artist? *

Your most valuable partnerships in your work are: *



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Kaizen will be reviewing your application privately and will be in touch shortly to discuss with you about whether a Cocahing Partnership would be mutually beneficial. Upon an agreement, you will be sent the link to invest in the Coaching Package that you desire. If you and the Coach decide together that this is not the best fit, Kaizen will provide you with some other options for you to pursue.

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