Question 1 - Your Details:

Your Name:

Parents Names

Location address

Date of Birth

School and Year:

Contact Number:

Contact Number of Parents

Email:

Email of Parents

Question 2 - Goals

Please your 3 tangible goals for;

(a) The next 12 months

1.

2.

3

(b) The next 3 months

1.

2.

3.

Question 3 - Obstacles

What obstacles are you struggling with at the moment that may prevent you achieving your goals?

Name 3 current challenges

1. 

2. 

3.

Question 4 - Improvements

What things do you enjoy doing and what do you need to do to double your happiness and fulfillment over the next 12 months

List the 3 things do you enjoy doing (in order of priority)

1.

2.

3.

List the 3 things you need to do to your happiness and fulfillment over the next 12 months

1.

2.

3.

Question 5 - Strategies Used

What Strategies have you already tried to improve your life that worked and didn't work

Strategies that worked

1.

2.

3.

Strategies that did not work

1.

2.

3.

Question 6 - Restraints

What do you think holds you back the most

Restraints

1.

2.

3.

Question 7 - Working with a Coach

1. Why would you like to work with a Coach?

2. Have you worked with a Coach previously - sports, music etc? f yes, what were your experiences?

3. What objections would you have to working with a Coach in the future?