Application for ACTion Team

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Coaching with Leslie
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*

Area CodePhone Number
Where did you hear about coaching with Leslie?*
What is your profession?*

Performing Artist (Actor, musician, songwriter, etc)WriterCreative (Director, Creative Director, Producer, Choreographer, etc)Entrepreneur or wanting to be oneVisual Artist (of any kind)Other
What program are you most interested in?*

Single Power SessionOngoing Monthly CoachingWow Project CoachingMasterminds
What would you like to gain from the coaching process*

I'm super stuck and need to figure out what I really wantI'm in a career transition and need help navigating the watersI have a project that I want to start or finish or bring to fruitionI'm an actor and want a career coachI want to start a business, or already have one and want to grow, sell or expand.Other
Why is it important to you now?*
What has held you back in the past?*
What's your biggest challenge you face right now that you'd like to tackle in our coaching together?*
If you could have your "rockstar" dream come true this year, what would that be?*
Are you ready to invest personally and financially to a 3-12 month program to transform your career and your life?*

YESNO
When are you most reachable by phone? (also, in the "other" box, please put your time zone. EST, PST, etc.*

Weekdays between 9 a.m. and noonWeekdays between noon and 5 pmWeekendsEvenings after 6 pmOther
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