Private Advisory Inquiry Form

with W.E. Da’Cruz, The Digital Diplomat™

Thank you for your interest in the Private Advisory Program. This form helps us understand your background, goals, and which signature program will serve you best. Please answer honestly and thoughtfully.

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 Diplomat’s Suite)

13. What is your greatest current challenges?

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

Section 4: Commitment & Readiness

15. Which program format are you most interested in?

Full Program: 12-Month Private Advisory (Single program focus)

Accelerator Track: (3) Private Advisory Sessions (Intensive)

The Diplomat's Suite: 12-Month Private Advisory covering (All 4 Signature Programs)

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

Full payment

Quarterly payments

Monthly Payments

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?

Next Steps:

Once you've submitted your application, it'll be reviewed. If aligned, we will follow up with the next steps for enrollment in either the 12-Month Private Advisory, the 3-Session Accelerator Track, or the Diplomat's Suite (12 months of all signature programs).

Check your text and/or email for additional details. We look forward to supporting your growth!