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VIP Member Info Form
Complete this form and click submit to sign up for membership.
First Name
Last Name
Date of Birth
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1. What brings you peace, happiness and fulfillment?
2. What does an exceptional life of look like to you?
3. What meaningful goals would you like to achieve?
4. Why is this important for you to achieve your meaningful goals.?
5. Which areas of your life would you like to be more intentional about?
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Personal Growth & Mindset Development
Health: Physical, Mental, Emotional, Spiritual
Wealth: Finances, Business, Career, Abundance
Relationships: Family, Friends, Community, Communication
6. What challenges or obstacles are you experincing?
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Required
Lack of Clarity and Focus
Consistency & Maintaining Routines
Time & Energy Management
Overwhelmed and Stuck
Prioritizing & Organizing
7. List any other challenges or obstacles do you experience.
8. What is your current goal setting, planning and achievement method?
9. What's your occupation?
10. What's the best way to contact you?
I give consent to receive coaching services from Zenlae, LLC. I understand that the coaching services provided are for educational and personal development purposes only. They do not constitute legal, financial, therapeutic, mental health care or other professional advice. The descriptions of coaching services and potential outcomes are intended to convey the general nature of the services. Actual methods and results may vary based on individual client needs and circumstances. I voluntarily assume full responsibility for any decisions and actions arising from the coaching process and acknowledge that such decisions and actions are my own. While coaching aims to facilitate personal and professional growth, no specific outcomes are guaranteed. Results depend on individual effort, commitment, and external circumstances beyond the coach’s control. I assume full responsibility for services rendered and release Zenlae, LLC from any liabilities or damages. I hereby hold harmless and indemnify Zenlae, LLC, their principals, and agents from all claims and liability whatsoever.
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