First Name *

Last Name *

Email *

LinkedIn Profile Link *

Business Website

Phone *

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I will meet with you at the designated day and time at no cost to you. I expect you to treat this time as a paid coaching/consulting session. If you are a no-show for the meeting, you will not be able to book with me for 12 months. To agree, type “YES, I PROMISE” *

1. Who are you seeking support for? *

Yourself

Company/Team

Community

2. What is your primary reason for seeking coaching support (select all that apply)? *

3. What is your work & income status (select all that apply)? *

4. What is your current/most recent Title, Industry, & Role Focus? *

5. What stage are you in (select all that apply)? *

Just started a job search (less than 3 months)

Ongoing Job Search (more than 6 months)

Seeking paid board and speaking roles

Need help launching a profitable business (feel lost & frustrated)

Need to grow business revenue for organization or yourself

Need to strengthen leaders & improve engagement

6. What is your current salary range? (Please list your base salary. If you quit or were impacted by layoffs, simply list your most recent earnings.)

8. Tell me about where you’re at right now in your life that makes you want to get a new job, launch a business, scale business revenue, or increase engagement in your workforce/community? Challenges? *

9. What do you feel is the biggest obstacle(s) that's stopping you from hitting your goals on your own? *

10. In 6 months from now, what success outcomes do you want to see for yourself or the organization (i.e., mindset shifts, earnings, business revenue, talent capacity)? *

11. On a scale of 1-10, how important are your success outcomes in your life right now? *

13. What appeals to you about working with me to help you reach your goals? *

14. If your application is accepted and you discover that working with Jessica is the right fit to solve your problems, are you ready to create the life you want and do you have the ability to invest financially into your career or your business right now? *

Yes

15. How much are you willing to invest in your development through my coaching services? *

I’m not willing to invest financially at this time

Less than $3,500 (Payment Plans as high as $168/month via Klarna)

Between $3,500 - $7,500 (Payment Plans from $168 - $360/month via Klarna)

Between $7,500 - $10,000 (Payment Plans from $360 - $480 month via Klarna)

I'm willing to invest any amount to get unstuck