Personal Details

First Name

Last Name

Phone *

Email *

LinkedIn Profile *

City

State

Professional Background

Employment Status *

If unemployed, put N/A

Employed full time
Employed part time
Unemployed
Freelance or self-employed
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What is your current job title? *

Briefly describe your current position or career situation. *

Career Goals + Motivation

What is your top career goal right now? *

What challenges are you currently facing in achieving this goal? *

Why are you interested in joining the Career Clarity Intensive? *

How do you think this program will help you achieve your goals? *

Commitment and Readiness

Are you ready to dedicate time to self-reflection, skill-building, and actionable planning over the next 90 days? *

Yes, I’m ready to commit.
I’m not sure yet.
No, I may need more time.
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Are you prepared to invest in your personal and professional growth financially? *

Yes, I’m ready to invest.
I need more information about the program cost.
No, I’m not ready at this time.
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Additional Information

Is there anything else you’d like us to know about your career journey or goals?

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