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1:1 Coaching Application Page

Ready to scale with strategy and support?

Fill out this short application to be considered for our 1:1 Business Coaching program. We’ll review your goals, challenges, and readiness to grow—and if it’s a fit, we’ll invite you to book a discovery call to get started.

Apply for 1:1 Customer Success Coaching

Let’s build a business that grows because your customers stay.

This coaching is for founders, service-based business owners, and small teams ready to reduce churn, improve client retention, and scale sustainably using proven Customer Success systems.

I work closely with each client, so I’m selective about who I take on. Please answer the following questions openly — I review every application personally.

Section 1: Contact Information

First Name *

Last Name *

Email *

Phone *

Business Name *

Website (if applicable)

Section 2: Business Snapshot

What type of business do you run?

How long have you been in Business?

What is your biggest challenge with customer retention or post-sale delivery right now?

How many active clients or customers do you currently serve?

What’s your current monthly revenue? *

Under $5k

$5k–$10k

$10k–$25k

$25k–$50k

$50k+

What’s your ideal goal in the next 6–12 months?

Section 3: Goals & Vision

Describe your long-term business vision. Where do you want to take your business?

Why do you think now is the right time for Customer Success Coaching?

What would success look like after 90 days of working together?

Section 4: Commitment & Fit

Have you worked with a coach or mentor before?

Which coaching package are you most interested in? *

90-Day Customer Success Sprint

6-Month Success Accelerator

12-Month CEO Success Builder

Not sure yet — let’s discuss

Are you ready and financially able to invest in coaching right now? *

Yes, I’m ready to invest.

I could if you have payment options available.

Possibly, I’d need to understand the value.

No, I’m not in a position to invest right now.

Are you committed to showing up fully, doing the work, and implementing the strategy?

Absolutely

I’m unsure

Section 5: Final Notes

Anything else you'd like to share with Jeremy?

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