APPLICATION FOR DATING & RELATIONSHIP COACHING

Thank you for your interest in working with me (Jonathon Aslay). I’m excited to get to know you better, and for the opportunity to help you the best I can with any and all of your dating, mating, and relating questions.

Please note, this no-cost discovery call is to determine if working with a coach is right for you and if you’re a good fit for one of my paid programs. If after reading your questionnaire I don’t believe we are a fit, I will write to you in advance of the call.

In order for us to have a productive & helpful conversation, please take a few minutes to fill out the form below. The more details you can give, the better I am able to determine if I’m the right person to help you. (Note: all information you provide is held in the strictest of confidence and will not be shared with any 3rd party.)

Once you’ve filled out the questionnaire, you’ll be redirected to a scheduling app (if you’re ready to hire a coach), where you can choose a time for our call that is convenient for you. Time slots are listed as 30 minutes for scheduling purposes, and your actual call length may vary between 15-25 minutes.

Looking forward to connecting with you.

Discovery Call

Product

Discovery Call: $0.00

Your Name *

Your Email Address *

Cell Phone Number *

If outside the US, you must include a Skype or WhatsApp number

Country Where You Live *

City/State/Province Where You Live *

What is your age? *

Do you have children? If so, what are their ages/gender? *

Lifestyle Question: What is your annual income? *

Under $40,000

$41,000 to $70,000

$71,000 to $100,000

$101,000 to $150,000

Over $151,000

Lifestyle Question: What is the ideal annual income of the man you'd like to date? *

Under $40,000

$41,000 to $70,000

$71,000 to $100,000

$101,000 to $150,000

Over $151,000

His income doesn't matter.

Lifestyle Question: What is your occupation and job title? *

Are you currently dating someone or in a relationship? *

Yes

No

If yes, how long have you been seeing each other?

What issues are you currently facing in your relationship that you need help with? *

When was your last relationship and why and how did it end? *

What if any work have you done in the area of personal growth, such as other coaching, reading self-help books. etc? *

What's your burning question for today? *

What do you feel has prevented you from finding lasting love or relationship success at this time? *

When you're in a relationship, what are your biggest fears and insecurities? *

What beliefs do you have about yourself that limit your thinking as to what's available to you in a relationship (e.g. there are no good men out there)? *

What are the two things you'd like to learn from a dating and relationship coach? *

Are you currently on one or more dating sites?

Yes

No

List the sites you use. *

Where and when did you find me? *

Right now... *

I understand that coaching requires an investment in the range of $1750 up to $5,000 and I have the financial resources to hire a coach.

I understand that coaching requires a significant investment, and I can find the financial resources to hire a coach.

I do not have the resources to invest in coaching (even if a one-time session is $450).

Why should I consider taking you on as a client right now? (What makes you coachable?) *

Upload a Photo

Drop a file here or click to upload Choose File

Maximum upload size: 2.1MB

I'd love to have a better sense of who you are, and a photo can help. Feel free to upload a headshot if you like.

If you are human, leave this field blank.

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Client Testimonial