Strategy Session Registration Form

Thanks for your interest in the Pivot with Purpose Program. Please answer the questions below. I'll be in touch shortly to provide schedule a complimentary 30-minute Career Clarity Session to see how we vibe and better understand your goals.

Pivot with Purpose is a 12-week online coaching program that includes: 3 individual coaching sessions and 9 professional development modules. An Internet connection is required for video conferencing (Zoom), email and web-based access to course content.

The investment for Pivot with Purpose is $997 - a payment plan is available. Registrants paying in full upfront will receive an additional 1-on-1 coaching session ($250 value).

Name*

First NameLast Name

E-mail*

Address*

Street Address

Street Address Line 2

State / Province

Country

How committed are you to make a change at work?*

	1	2	3	4	5	6	7	8	9	10

1 is Not at all, 10 is Fully Committed

What are your 3 most important career goals for the year ahead?*

How would your life change if you could achieve the goals listed above?*

What's holding you back from making progress?*

Why do you want to work with me in the Pivot with Purpose Program?*

Which statement(s) best describes your current situation? (Choose up to 3)*

I am bored in my current role.I am burned out in my current role.I feel trapped by my degree and/or training.I want to re-energize my existing position.I am ready to reinvent myself for my next career.I want to apply my expertise in a new organization.I need to make a change but I don't know where to start.Other

I understand that the investment for 'Pivot with Purpose' is $997 for 12 weeks (this is an acknowledgment, not a commitment).*

YesNo

Would you like to join the 'Engineer Your Bliss' community and receive periodic updates via email?

YesNo

Application: Pivot with Purpose Program