Name
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First Name
Last Name
Email
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Location & Time Zone
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What is your current role & company?
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How many people report to you (directly and indirectly)?
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What is your company's (or business) annual revenue/size?
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How long have you been in a senior leadership role/business owner?
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Yes
No
What is the most significant leadership challenge you're currently facing?
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What strategic decisions are you wrestling with right now?
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What patterns do you notice in your leadership that aren't serving you?
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How do you currently handle strategic guidance and decision-making support?
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Why are you seeking strategic advisory support now?
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Coaching style match
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Which best describes how you like to be coached? There's no right or wrong answer, I simply need to know how you operate.
Direct, blunt, cut-through-the-noise
Collaborative, co-created reflection
Deeply intuitive, emotion-led
Strategy-first, results-driven
A blend - I flex depending on the moment
What would need to shift for you to consider this advisory relationship successful?
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What's your timeline for making a decision about strategic advisory support?
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I work with executives/business owners ready to begin strategic advisory within 30 days. Applications for future consideration are welcome but will be prioritised accordingly.
Within 2 weeks
Within 30 days
Within 3 months
Commitment & Readiness
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Working with me requires a high level of commitment. This is for those who are serious about growth and execution, not just collecting more information. Are you fully prepared to take action, implement, and be coachable?
Yes
No
Calendar Integrity Commitment
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Appointments can be rescheduled once, as I fully understand life happens. However, reschedules must be made at least 24 hours in advance.
All appointments (across every container I offer) must be used within 12 months of your start date - no exceptions.
This protects both your progress and my energetic availability.
I agree
I don't agree
Financial Readiness
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My coaching requires an upfront investment, and I do not offer refunds or payment plans. This is a high-level experience designed for those who are financially prepared to invest in their growth. Are you in a position to make this investment?
I am
I am not
Accountability & Execution Committment
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Working with me isn’t just about gaining insights - it’s about taking action. I expect my clients to implement, stretch themselves, and do the work. If you’re looking for someone to ‘convince’ you to take action, this isn’t the space for you. If you’re looking for someone who just ‘tells’ you what to do, this isn’t the space for you. If you’re the kind of person who doesn’t do accountability or homework, this isn’t the right space for you. Are you prepared to take full responsibility for your results?
I am
I am not
Zoom screening call
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If your application is approved, I may invite you to a 10-minute Zoom screening call to ensure we’re a strong fit for working together. This is NOT a sales call - it is a chance for us to connect, for me to get a sense of your energy, and for you to confirm that this is the right coaching experience for you.
To maintain transparency and protect both of us, this call with be audio recorded. This ensures clarity around expectations, commitments, and agreements. By selecting ‘Yes’ below, you acknowledge and consent to the recording’
Yes
No
Contract Signing
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If your application is approved and we move forward, you will be required to sign a contract before coaching begins. This contract outlines the terms of our work together, including expectations, commitments, and payment policies. No appointments will commence until the contract is signed.
By selecting ‘Yes’ below, you acknowledge that, if approved, you will be required to sign a contract before working together.
Yes
No
Payment Clause
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If your application is successful, payment is required within 14 business days to secure your place. If payment is not received by then, the offer will expire and your spot will be reallocated without notice.
Yes - I understand and will be able to pay within 14 business days
No - I am unable to do this
Values Clause
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My space is built on integrity, self-awareness, and inclusivity. I am openly queer, and I do not tolerate racism, discrimination, or misaligned values in my work. If we work together, you are stepping into a space that prioritises respect, equality, personal responsibility, and deep growth. Does this align with you?
Yes
No
By submitting this application, you acknowledge and agree that, should you be approved and choose to work with me, your payment is final. There are no refunds for change of mind or if you do not achieve the outcome you hoped for—your results are directly linked to your commitment and implementation of the agreed work. This policy upholds the integrity of this experience and honors the depth of the transformation you are investing in. Please ensure you are fully ready to move forward before applying.
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Yes
No