Private Coaching Application
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Complementary Peak Performance Strategy Call Application
First Name
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Last Name
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Primary Email
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Phone number
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What is your career industry?
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Company Name
Are you representing a Company? Complete this field with your Company Name. Or, if you are doing business as an Individual, then leave this field blank.
Job Title
What are your short term goals you want to accomplish in the next three months?
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What challenge/issue/question/opportunity would you like to address?
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What methods have you already tried to resolve this issue?
On a scale of High, Medium or Low how would you rate the importance of getting help to make these changes*
Make a selection
[High] I am actively looking for the right coach to engage with
[Medium] I will make a decision on the help that I would need in the next six months
[Low] I am not seeking help in this area at this time
Are you currently available to dedicate the time to commit to the preparation and implementation of your goals?
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Are you prepared financially to invest in coaching services or does your company cover coaching services for its employees?
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How do you think Shemeka Brathwaite can assist and support you? What are you looking for in a coach?
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When, would you like to begin your private or group coaching program?
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Immediately
1-2 months
3-6 months
Not sure at this time
Which services are you interested in?
VIP Day
Retreat
Private Coaching
Group Coaching
Online Course(s)
Masterclass
Book
I am open to discussing a variety of available options
Company Name
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Company Name
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Company Name
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