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Application For Private 1:1 Coaching With Gina

Hi Beautiful Soul! I'm so excited you're here!

This application form is for women who want to start or grow a business with me as their private 1:1 mentor and coach in either the 3, 6, and 12 month option.

The purpose of this application is to help me get to know you more, to make sure we are a great fit.

So please take your time with this, then click submit so I can make a decision about the two spots I am enrolling for soon, and we have the best chance of getting started right away.

I will reach out by email or on social media within 72 hours after you submit.

Speak to you soon,

Gina

 

Click the button below to start.

Start

Question 1 of 19

Your First and Last Name:

Question 2 of 19

Email address:

Question 3 of 19

Where can I get to know you online? Name the social media platform that you've been most active on and share your username with me. Mine is @empoweredaftertrauma so be sure to follow me on your favourite social platform in case I want to send you a message there.

Question 4 of 19

If you have a business website, share it here, along with how many years you've been in business and how you feel about it? This is 100% confidential and there are no wrong answers, just share honestly here - including triggers, patterns you notice, what's working, what's not.

Question 5 of 19

Tell me about your dream business - what you see for it, what you really really want for it. Pretend there are no obstacles, just share your heart's vision for it here, I want to feel and know it with you!

Question 6 of 19

What’s happening in your life or business right now that has you reaching out to me? What do you wish for me to help you with and what’s the end goal you wish to achieve with my help?

Question 7 of 19

If you don't have a business yet, what do you do for a living? How long have you been doing it? (Type "N/A" if you do have a business or if it's new, share what you were doing before)

Question 8 of 19

What’s the range of your current monthly income, whether from business revenue or other income or both? The following choices are in USD.

A

$ 50K + consistently per month

B

$30-50K consistently per month

C

$10-30K consistently per month

D

$5-10K consistently per month

E

Less than $5K per month

Question 9 of 19

If I could wave a magic wand, and give you exactly what you want by the end of our time together, what would that look like?

Question 10 of 19

How would you describe your communication style?

A

Strong, authentic communicator even if it's uncomfortable, in all areas of life

B

I tend to over-communicate, because I want to make sure everyone is ok, and I get anxious if I think someone is mad at me or might end our relationship

C

I don't enjoy communicating a lot so most of the time I avoid conflict. I feel overwhelmed and I ghost people because of it.

D

It really depends on the area of life for me. I have different styles for different situations.

Question 11 of 19

What is your greatest support system right now? 

A

Coach/therapists (Maybe even multiple)

B

Spouse/long-term partner

C

Family/parents/sibling

D

Friends/Community

E

I don't really have one right now.

Question 12 of 19

Have you done any trauma counselling or coaching? Please list what you have done because it helps me understand your background. Also share if it helped you or not, what your experience was like.

Question 13 of 19

Do you feel like you need urgent or crisis help with your trauma right now?  Do you feel like you're in crisis often? Kindly share your experience with trauma crisis and where you are at with it right now. Know there is zero judgment here, I just need to make sure you get the exact help that you need.

Question 14 of 19

What is your general mood and energy level like on a day-to-day basis? (Choose the closest answer to what these are like for you).

A

High good energy levels, I feel content, happy, fulfilled overall but always wanting to evolve and grow

B

High energy, anxiety, have trouble relaxing

C

Low energy, burnt out, I struggle with depression and motivation at times

Question 15 of 19

What made you choose me (Gina) to work with, specifically?

Question 16 of 19

Are you comfortable exploring modalities such as learning new communication skills, journaling, breath work, yoga, somatic tools, manifestation, inner child work, meditation?

A

Yes.

B

No.

Question 17 of 19

What is your current budget for investing in this coaching support? This application process is for potential private 1:1 mentoring clients only: 

A

$2,555 + monthly for private 1:1 mentoring (select this option then continue with this application process and submit when complete)

B

$1,555 total for a 3 month mastermind (leave this application process and go to “mastermind” from main menu on my website EmpoweredAfterTrauma.com)

C

$555 total for a live six week program (go to “Portal 555”  from main menu on my website EmpoweredAfterTrauma.com)

D

$222 for one month of a membership program (go to “Against All Odds Woman Membership”  from main menu on my website EmpoweredAfterTrauma.com)

E

Under $222 for a single Do-It-Yourself program (browse my website for mini courses at EmpoweredAfterTrauma.com)

Question 18 of 19

This package is only for a handful of people who feel deeply connected to my life's work and who understand the commitment of time and energy that is involved, in the best of ways, for both of us, at this level.

So it does require an investment of $6,500 USD for 3 months or $2,555 USD per month. (This option includes regular sessions, 24/7 access to a communication app that is confidential for only you and I, as well as access to some of my digital programs). 

Is this something you're able to invest in yourself at this time?

A

Yes I can do the 3 month option (Payment Plan)

B

Yes I can do the 3 month option (Pay In Full)

C

No I am not able to do this yet. (If you choose this option, close the application for now then come back when you're ready or contact me on social media for a different program recommendation)

Question 19 of 19

FINAL QUESTION (OPTIONAL): Do you have questions before enrolling in this coaching and mentoring program? Please list them here, then I will contact you to see if you would like a brief phone call to discuss or if I can just answer them quickly via email or on social media messaging for you.

 

Confirm and Submit