Please let me know more about you Please allow 15 minutes or more to answer these questions. First Name* Email* Phone* In what City / State / Country do you live?* How do you know about Pauline?* Referral Heard you speak Social Media Read your book Purchased your product Other If Other - Please specify. What is your profession?* Are you happy in your current profession?* Yes No What are your Professional Goals?* Do you have a Dream? Would you care to share it?* In order of importance to you, order the following human needs from 1-6. Significance Certainty Variety Growth Love & Connection Contribution* In order of importance, which best describes you? Order the following traits from 1-4. Determined and Driven, Spontaneous and Carefree, Skeptical and Analytical, Always put the needs of others first* What do you want to experience in LIFE?* How do you want to GROW?* What do you want to CONTRIBUTE?* What is your reason for wanting a coach / mentor?* Developmental work Speaking/Communication One-off session with Pauline Other Other: Please specify.* Why would you like to be coached / mentored by Pauline Nguyen?* List any relevant assessments you have recently had that could be provided so that Pauline can understand you better.* Have you ever had a coach / mentor before?* Yes No Pauline receives hundreds of requests for mentoring every year. There are simply not enough hours in the day for her to coach / mentor everyone so she must be selective with whom she works. Why should she work with you?* How soon would you like to get started?* Submit