1up Coaching Application

In order to have a valuable Breakthrough Coaching Experience, it's important we know who you are so we can be prepared and you can get the most out of our time together.

Click the button below to start.


Question 1 of 12

Please enter the following:

– Full Name

– Email Address

– Your age

– City, state (and country, if outside the US) of where you live

– Current occupation

Question 2 of 12

What areas of your life feel the STRONGEST right now?

How are you able to maintain a high level in these areas?

Question 3 of 12

What areas of your life feel WEAK right now? Why?

Question 4 of 12

What would you want your life look like 12 months from now if you could make it happen?

Question 5 of 12

What is the ONE thing you feel like you need to understand NOW about yourself that would allow you to start creating that life?

Question 6 of 12

Have you previously invested into improving your life?

If so, explain.

Now seeing everything and having (almost) completed this application...

Question 8 of 12

...What are the COSTS of you NOT investing in yourself and the life you want?

Question 9 of 12

WHY do you feel I am the right coach to guide you through this stage of your life?

Question 10 of 12

"I am ready and willing to invest time, energy, and money into myself and my life."


Breakthrough conversations are reserved for those ready to make an investment in themselves on the call.



YES! I have the ability to invest now.


Yes, if I had the option of a monthly payment plan.

Question 11 of 12

It's important to me that you make the right choice for you, so please do your own research (Google, Facebook, etc) on me prior to the call, so that we can come together ready to do the work.


YES, I will definitely do research on you before my call!


Yes, I might do some research, but I already know this is RIGHT for me.

Question 12 of 12

What's your favorite game?

Confirm and Submit