Happiness Matters Application

Name*

First Last

Date*

Email*

Phone*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Website (if applicable)

How did you find me? (please be as specific as possible)*

Interested in:*

Mastery Coaching program
VIP day
Not sure yet

Which format:*

Private
Group

Briefly describe your life: What do you do? Are you married? Do you have kids? What is your life and career like right now?*

What are your most pressing challenges that have driven you to seek out support? What's your biggest struggles related to time and money in your business. Please be as specific as possible.*

How are these challenges or problems impacting your life, including relationships, finances, health and overall level of happiness?*

What is the cost of NOT overcoming the challenges you indicated above. Please be specific and focus on what matters to you, such as your relationships, home life, peace of mind, lost time, business income and financial success, etc.*

What is the #1 biggest obstacle that has kept you from solving these challenges?*

Have you tried to solve the problem(s), and if so, what have you already tried that didn’t work for you?*

Are you willing to step outside of your comfort zone and participate at 100% to achieve the results you desire?*

Yes, even though that might make me a bit uncomfortable.
No, I can't handle the stress of change.
I will do my best.

How do you feel when you wake up and think about the day ahead of you?*

If you could wave a magic wand and have your ideal [lifestyle / business / health / level of income / relationship], what would that look and feel like?*

Do you see the value of working with a coach and investing in yourself to achieve your happiness goals?*

Yes, I know my happiness is an investment.
No, I have a tough time justifying the expense.

Do you need to consult a spouse, business partner or someone else before making a commitment to the program? (If yes, please share the program information from our website with them before submitting your application).*

Yes.
No.

Have you worked with other coaches before? Please list any training or mentoring programs that you are currently in or have completed in the past.*

What are your top 3 goals you want to accomplish during our time together?

Is there anything else you'd like Jennifer to know?

Congratulations!

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