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TMLR Application Form (v.2022.06)

Hello. Thanks for your interest in The Midlife Reset

Click the Let's Start button to apply to join The Midlife Reset. Once completed, we will review your application and contact you.
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Hey there, my name is Jonathan. I'm the head coach and founder here at Legacy Coaching.
Click "GO" and let me know about you ...
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2
What is your FIRST NAME?
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3
... and your LAST NAME?
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4
Thanks {{ 2. What is your FIRST NAME? }} . Why do you want to join The Midlife Reset?
Why is The Reset right for you?
Max. characters 300
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5
Why is now the right time for you to reset your life?
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6
What part of The Midlife Reset interests you the most?
Help us to understand which area excites you and you think you might get the most out of.
  • A Get out of constant survival
  • B A life direction that energises you
  • C Discover stability, confidence, peace
  • D Overcome obstacles, get momentum
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7
You chose {{ 6. What part of <em>The Midlife Reset</em> interests you the most? : selected }} . Describe why this area interests you the most.
Max. characters 300
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8
Is there a specific issue/challenge that you are wanting to overcome?
  • A YES
  • B NO
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9
How long has this been a challenge for you?
Rough estimate, please
  • A A few MONTHS
  • B A few YEARS
  • C 3-5 YEARS
  • D 5-10 YEARS
  • E More than 10 YEARS
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10
How big of a problem is this for you?
Drag the slider to the appropriate level (0 = low, 100 = high)
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11
What is this challenge costing you?
What can't you do?
Is this impacting your work, your health, your relationships, your business, your recreation?
Max. characters 300
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12
What would life look like if you no longer had this challenge?
How would you feel? What could you do?
Max. characters 300
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13
What's your best email address {{ 2. What is your FIRST NAME? }} ?
We NEVER spam
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Please enter valid email address

Thank you for your interest and for taking the time to let us know a little more about you.

We will contact you shortly with more information or the next steps.

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