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Crossed Stakes Coaching Application

Name

*

Email Address

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Age

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Current Occupation

*

Why are you interested in this coaching right now?

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What are the main areas you want to work on? (check all that apply)

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What are the main areas you want to work on? (check all that apply)

Discipline / Follow Through

Fitness / Training Consistency

Daily Routines and Structure

Ending Bad Habits

Focus and Clarity

Other

What are you struggling with the most right now?

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On a scale of 1–10, how willing are you to be held accountable and challenged directly?

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On a scale of 1–10, how willing are you to be held accountable and challenged directly?

1

2

3

4

5

6

7

8

9

10

This coaching requires weekly effort outside of calls. Are you willing to commit to that?

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If accepted, are you prepared to invest financially in this coaching?

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