WC4S Application | WC4S

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Email Us : wc4s2016@gmail.com

Reach Us : 813 951-4268

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Apply today to start your new journey with the focused care and guidance of a Life Coach. Upon submitting your application, a life coach will contact you within 24 hours.

Privacy Policy

Your privacy and discretion is our top priority. Please review our privacy policy for more details on how we keep your information safe.

WC4S Client Application

Please complete the following form and respond appropriately to be considered as a client for our program. This initial screening application will take approximately 5-10 minutes to complete

Full Name

Phone Number

Email

Address

I am 18 years of age or older, English speaking, live in the USA or Canada

Yes

No

Schedule the Discovery Call

Select a time

At this time, we're only accepting applicants with an annual HOUSHOLD INCOME of $40,000 or less (Adjusted Gross Income). Please include income from all members living in your household for this amount. (If you have just lost a job or in transition and expect your household income to be less than $40,000 in the next 12 months, you may answer according to your expected income) Please check the box to confirm that your household AGI is less than $40,000 per year

Household Details

Select your program of interest

1.) Tell us a little about yourself and your current situation

2.) What do you hope to accomplish by working with a coach at this time?

3.) Why do you think you would be a good candidate for this coaching program?

Whats your preferred coaching schedule? Please provide 3 options (Day and Time)

WC4S Surveys & Feedback - If accepted into the program, I agree to complete an initial client intake survey when my program begins as well as a debrief survey at end of the sessions within 2 weeks of last session.

Program Requirements

Coaching Acknowledgement - I understand that the coaching sessions are offered in-person and virtually via telephone or Zoom. I agree to attend regularly scheduled coaching sessions as agreed upon with coach and that I will provide coach with 24 hour notice if unable to make scheduled time. I understand that if I am accepted for the program, my program will include up to 4 or 6 sessions with my assigned coach that must be used within 6 months of being accepted to the program.

4 Week Coaching Program

6 Week Coaching Program

Select your program of interest

Complete payment

4 Week Coaching Program - $40.00

6 Week Coaching Program - $60.00

Women Centered 4 Success is a 501(c)(3) nonprofit organization in based Tampa, Florida and all gifts are tax deductible as allowed by law.

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CONTACT US

wc4s2016@gmail.com

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