Pre-Qualification Form
Receive private one-on-one coaching for the greatest opportunity to develop in the shortest amount of time.

I personally review all applications and only respond to the applications in which I feel we will be a good fit working together as I take my coaching very seriously, and will pour my heart into working with you.

It means the world to me to see someone transform their life for the better.  I look forward to helping you become the best version of yourself!

-George
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What is your name? *
What is your best email address? *
What is your age?
Where are you currently located? *
Country, State
How serious are you about receiving coaching and quitting marijuana? *
How long have you been smoking weed for? *
Have you tried to quit weed before? How many times? What happened?
Why do you want to quit smoking weed? *
What kind of coaching would be most helpful to you?
What really are you hoping to receive from this coaching experience? Please elaborate so that I know best how to serve you.
Are you currently working? If so, what is your current career?
What are some goals/dreams of yours that you would love to accomplish over the next year?
Please understand that one-on-one coaching is a paid service.  I keep my rates reasonable, and I pour my heart and soul into providing you with as much value as possible.  Are you willing to invest in coaching? If so, how quickly are you looking to get started?
What is the best number to call you on? *
What is the best time of day to call you? *
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