What areas are you looking for help with specifically?
*
Self-Worth
Personal Empowerment
Growth Mentality
Self-Discipline
Authenticity
Emotional Awareness
Resiliency
Mindfulness
Balance
Communication
Goal Setting / Future Planning
Purposeful Living
Time Management
Other
(Check all that apply)
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Have you (or your teenager/young adult) experienced any of the following?
*
School shooting
Anxiety
Domestic Abuse
Prejudice
Depression
ADHD
Occasional Self-Doubt
Lack of Direction
Negative Self-Esteem
Low Self-Confidence
Eating Disorders
Body Dysmorphia
Bullying
Feeling Lost
Divorced / Parents Separated
Other
(Check all that apply)
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What is your timeline for working with a personalized mentor-coach?
*
I’d like to get started ASAP
I'd like to get started within a week or two
I'd like to get started in the next few months
I’m not sure, I’m just looking into my options
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Has something recently occurred in you or your teenager/young adult’s life that has led you to seek life coaching?
*
Yes
No
Not Sure
If you are feeling unsure about Mentor-Coaching, what is your main concern currently?
*
Cost
How to ask my child if they are interested
I don't know if it will help my child
Something else
Please Describe:
*
What age is your child?
*
Select age
10-12
13-15
16-18
19-25
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How much are you able to invest each month for your teenager/young adult to become their best self?
*
$100-$199
$200-$299
$300-$399
I am unable to invest anything at this time
I am willing to spend over $400 per month
I am not sure right now
What else are you interested in learning about Positive Presence and our Mentor-Coaching Program at this time?
*
How much does it cost
How students are matched with mentor-coaches
How we know it works
What the mentor-coaches do with their students
Something else
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First Name:
*
Last Name:
*
Email:
*
Which Coaching Program are You Interested In?
*
Select Coaching Program
Female Coaching Program
Male Life Coaching Program
LGBTQIA+ Coaching Program
Parent Coaching Program
Are there other people in the household that would benefit from our other mentor-coaching programs including pre-teens, teens, college-aged, parents and adults?
*
Yes
No
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Best Contact Number:
*
Can we text you?
*
YES
I'd prefer a phone call
What time zone are you in?
*
Select time zone
Eastern
Central
Mountain
Pacific
Hawaii
Alaska
Arizona
How did you hear about us?
*
Select source please
Facebook
Google
Instagram
Email
Current Coach
Current Student
Michelle Marie King
Other
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