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. Are you committed to investing in yourself?
  10. Have you experienced coaching, counselling or healing work before? If so, were you satisfied with the outcome?
  11. What would be the ideal outcome of our work together?
  12. Do you have a daily practise, like for example meditation, qigong or yoga?
  13. What do you feel you need the most to support you in this phase of your spiritual and personal growth?
  14. Is there anything else you’d like me to know?
  15. SCHEDULING Let me know your location (country, state, city) and a few possible dates and times that would work for you to connect via Zoom (preferred) or Skype including your Zoom or Skype ID (user name). If you are in the US, choose a time after 3pm; for Europe, it will have to be before 10am. I am in New Zealand, which means it is a time zone that is in "the future" :). For more details Please use this time zone converter.

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

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I do not claim to be a medical practitioner, nor do I promise to diagnose or cure any illness. You agree to take full responsibility for your own health and well being.