Apply for Mentorship

Please answer the following questions:

You can copy these into a text editor, answer the questions and copy the text back to the answer form.

  1. What is your full name and date of birth?
  2. Do you have a website?
  3. What is your Skype ID and / or Facebook name?
  4. How did you hear about me? Youtube, Google Search, Facebook, Word of Mouth, Other
  5. What about my work inspired you to contact me?
  6. Tell me more about who you are and your background. Help me to get to know you better.
  7. What areas are you finding most challenging in your life? Tell me more about your challenge and how you would like to see it shift?
  8. What do you do for a living?
  9. Have you experienced coaching, counselling or healing work before? If so, were you satisfied with the outcome?
  10. What would be the ideal outcome of our work together?
  11. Do you have a daily practise, like for example meditation, qigong or yoga?
  12. What do you feel you need the most to support you in this phase of your spiritual and personal growth?
  13. Is there anything else you’d like me to know?

After I review your answers, I will get back to you and you can book yourself into my calendar then.


Note: Please fill out the fields marked with an asterisk.

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