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group
Application
By completing this application we can direct you to a group that is the BEST fit.
Step
1
of
5
20%
Your Personal Information
Your Name
(Required)
First
Last
Your Email Address
(Required)
Enter Email
Confirm Email
Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Your Phone
(Required)
Best Time To Call You
(Required)
When is the best time for us to reach you via telephone?
Mornings
Early Afternoon
Late Afternoon
Early Evening
Previous Coaching Experience
Have you coached with Danielle Fenster 1:1 for 6 Months or Longer?
(Required)
Yes
No
What was that experience like for you?
(Required)
Have you ever worked with a coach 1:1?
(Required)
Yes
No
What was the focus of the work?
(Required)
Did you get the outcome you were expecting?
(Required)
Why or Why Not?
Have you ever been part of group coaching?
(Required)
Yes
No
What was the focus of the group?
(Required)
Was the outcome you desired achieved?
(Required)
Why or Why Not?
Current Situation
What is your biggest point of pain or frustration?
(Required)
What is your second?
(Required)
What have you done in the past to address these two areas of concern?
(Required)
What do you want these two areas of your life to look like?
(Required)
Let's dream here, if truly nothing was impossible, what would they be like?
What do you think is keeping you from getting the result(s) you desire?
(Required)
Desired Outcome
What is one thing in your life, that if that happened, would absolutely blow your mind?
(Required)
What are you wanting to get out of this group?
(Required)
If you knew that this group could yield you these outcomes, how much would you invest monthly?
(Required)
$500
$501 - $750
$751 - $1,000
$1,000 +
Other
Lastly, are you currently a coach?
(Required)
Yes
No
Enrollment
Based on the information you provided the group that is the BEST fit for you is;
Refined by Fire Group Coaching
(Required)
Weekly group coaching call that has the following renewal options;
Monthly
Yearly
Fusion Group Coaching
(Required)
Weekly group coaching call that has the following renewal options;
Monthly
Annual
Total
Credit Card
(Required)
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