Section 1:Personal Information

Full Name *

Email Address *

Phone Number *

Current Location(City/Country) *

LinkedIn or Website(optional)

Section 2: Professional Background

6. Current Role/Title *

7. Organization/Business Name: *

8. Industry/Field: *

9. Years of Leadership or Speaking *

0-2 years

3-5 years

6-10 years

10+years

Section 3: Goals & Challenges

10. What motivated you to seek private advisory at this time? *

11. Which of the following outcomes best describe your current priority? (Select up to 2) *

Elevating my voice and developing a signature message (Speaker Program)

Strengthening my leadership presence beyond titles (Leader Program)

Designing business strategies for growth and sustainability (Strategist Program)

Expanding my global influence and reach (Influencer Program)

Experiencing all signature programs (The Suite)

13. What is your greatest current challenges? *

14. What would success in this advisory relationship look like to you? *

Section 4: Commitment & Readiness

16. How do you prefer to invest in your growth? *

Full payment

Quarterly payments

Monthly payments

I am flexible

17. How committed are you to applying what you learn to create transformation in your life/business? *

Fully committed

Somewhat committed

Unsure

Section 5: Additional Notes

18.Is there anything else you'd like me to know before we begin?