Welcome.

Thank you so much for your interest in the 6-month group coaching program.

Please answer the questions below, so I can gain a well-rounded understanding of who you are, and what you're looking for and to ensure the program is a fit for you.

But before you fill out the form, please make you sure you've carefully read the information on the From The Core page.

Thank you & I look forward to speaking to you soon.
‍
All the best,
Jord

1. Personal information

First Name:*

Last Name:*

Email:*

Phone:*

Instagram

How did you hear about me?

2. Background

Please tell me about yourself - Where are you from? Your age? The nature of your work or business?*

3. Current circumstances

Why do you believe now is the right moment for mentorship in your life/career?*

What are the top three most present challenges you're currently facing?*

4. Purpose of mentorship

What key outcomes/experiences do you hope to achieve through this mentorship?*

5. Commitment

On a scale of 1-10, how important is this matter to you? Please explain why you’re ready to commit to yourself and this process. *

The investment for this program is $ 4,500 USD. Are you in a position to invest in yourself at this level? *

YESNo

If this program is right for you, are you able and willing to attend the weekly calls? *

YESNo

If this program is right for you, are you willing to participate in group work? *

YESNo

4. Questions and/or thoughts

Is there anything else you want me to know before the call? Any questions or thoughts are welcome.

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Group Coaching

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Welcome.

1. Personal information

2. Background

3. Current circumstances

4. Purpose of mentorship

5. Commitment

4. Questions and/or thoughts