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Mentorship Application Form

First name

Last name / family name

Email address

Website URL

Facebook profile, Instagram handle, Voxer username

I'd love to say hello!

Where are you at in your business?

Where are you at in your business?
A
B
C
D
E

What are your three main goals for the next 6 months?

Why are you looking for mentorship?

No need to overthink this, just tell me what's not working and what you want to change.

Why do you want to work with me?

There are lots of people out there offering mentorship. Why do you think I would be a great mentor and coach for you?

Diversity, equity, and inclusion (DEI) is at the core of everything I do, including this mentorship program. How do you think of DEI in your business?

Diversity, equity, and inclusion (DEI) is at the core of everything I do, including this mentorship program. How do you think of DEI in your business?
A
B
C

Which payment plan are you interested in?

(You can change your mind later.)
Which payment plan are you interested in?
A
B

How did you find me?

How long have you been in my world?

How long (roughly) have you been reading my emails, or seeing my content on Facebook, Instagram, YouTube, etc.?