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Application For Sasha's Immersive Program
High End Coaching Application
Step
1
of
4
25%
Name
*
First
Last
Email
*
What industry are you in?
*
Country of Residence
*
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darrussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
US Minor Outlying Islands
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Phone
*
What would you like to get out of this coaching program?
*
What obstacles have been stopping you from reaching your goals?
*
Money
Self confidence
Discipline
Courage
Believe in myself
Get in contact w people
When you reach your goals, what will that look like? (How will you know that you've reached them? What will be different?). Be as specific as possible.*
*
I will feel happier.
I will have the courage to make it happen and I’ll be encouraging others too.
What else have you tried and what were your results (other programs, methods and coaches)?
*
Please select the one that best describes your current situation?
*
I am brand new to coaching and I’m looking for something different to reach my goals.
I’ve had coaching before, but I am still struggling to hit my goals.
I’m doing well, I just want to take myself to the next level.
I don’t need any help, I’m happy where I’m at.
How ready are you to receive outside help right now ?
*
I have already proven to myself that I do not have the skills to fix the problems on my own and I am actively looking for the right coach.
I still believe this is something I can figure out on my won but I’m open to learning from the best so I can implement what works on my own.
I am completely fine figuring things out on my own and will take outside help with a groan of salt.
Currently Monthly Income
*
Less than $2,500
$2,500 - $7,500
$7,500 - $15,000
$15,000 - $50,000
More than $50,000
Desired Monthly Income
*
$5,000 - $10,000
$10,000 - $20,000
$20,000 - $50,000
$50,000 - $100,000
More than $100,000
The High-End Coaching Program is only open to 3 people at this time, ONLY because we want to give them our full undivided attention.
*
Tell me about your self as a person and why you feel like you may be a good fit.
*
One of our coaches will call you at the time you choose. Please commit to the appointment by typing this sentence in the box below: “Yes, I promise to answer the phone when I'm called.”
Name
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