Section 1: About You
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First Name
Last Name
Email Address
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Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone Number
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(###)
###
####
Age Range
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18-24
25-34
35-44
45+
Favorite Coffee Order
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Section 2: Faith & Spiritual Walk
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Tell me about your relationship with Jesus. How long have you been walking with Him? Also, tell me about your parents relationship with Jesus. What is their story?
What + who do you sense the Lord is calling you to in this season?
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How active are you in your local church?
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Very active
Somewhat active
Not active but connected
Not connected
Section 3: Personal & Lifestyle
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What does your daily life look like? (Family, work, ministry, etc.)
What are your top 3 priorities right now?
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Body, Soul, Spirit
Where do you currently feel stuck, overwhelmed, or unclear?
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Section 4: Mentorship Readiness
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Why are you seeking mentorship at this time?
Have you ever worked with a mentor or coach before?
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If so, what was that experience like?
Section 5: Vision & Marketplace
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Do you currently own a business or ministry, or have an idea you are building? If yes, please describe.
What specific impact do you feel called to make for the Kingdom?
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What is the dream the Lord has put on your heart that feels "too big" but won't leave you alone?
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Section 6: Final
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What else should I know about you before we begin?
How did you hear about me?
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Are you prepared to make the financial and time investment into mentorship?
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Yes
No
Need to Discuss
