Scholarship Application Form

Name

Mobile Number

Please explain why this scholarship is important to you.

Please describe what your goals are for the programme. What would you like to be different after the four months?

Why are these changes (described above) important to you?

Please review the following 6 statements and tick any that apply to you. Share in the space below your concerns (if any).

I view coaching as an investment in myself and my future. I am ready to do the work necessary to get me where I want to be, and I will let the coach do the coaching. I am willing to change any self-defeating behaviors that are creating a barrier to my success. I accept responsibility for my actions and will not expect the coach to “fix” me, because I know I’m the only one who can make it happen. I am able to commit the time needed to attend the Coaching Circles and to do the work that my coach asks of me. I’m open to trying new things when my coach asks me. Even if they aren’t completely comfortable or I’m not convinced they will make a difference.

Please provide below any information or concerns you have regarding the six statements above.

Scholarship Application Form

SUZANNE SALTER

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