1. Life Coaching Application

First Name:
Last Name:
Street Address:
City:
State:	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee
Zip Code:
Phone:
Email Address:

2. Please tell us about your interests and your availability to meet with a life coach.

Interests:	( 250 character maximum )

3. What Life Goal from the Transformation Matrix are you interested in?

Click here to download a copy of the Transformation Matrix.
Matrix	Life Goal
Character	Love - I find it easy to be very understanding of people who criticize me and fail to live up to the standards I hold for them. Joy - I find pleasure in most everything I do and I am content with all that God has given to me. Peace - It is easy for me to forgive myself and others, and I am free form stress, anxiety, depression and fear. Patience - I am quite capable of handling periods of suffering and pressure without becoming irritable or frustrated. Kindness - I am quick to lend a hand when someone is in need or in trouble, expecting nothing in return. Faithfulness - I maintain my commitments to and think highly of those in authority over me and those who depend on me. Gentleness - I allow others to make mistakes without becoming withdrawn or angry when it is necessary to confront them. Self-Control - I manage my time and finances well without the interference of addictive or immoral behavior.
Home	Marital Situation - I am very content with my current marital situation, and I do not wrestle with any type of sexual immorality. Immediate Family - I have excellent relationships WITH everyone IN my immediate family AND communicate WITH them regularly. Finances - I view my finances and possessions as blessings from God, giving generously and spending wisely with no indebtedness. Free-time - I regularly take time for myself, engaging in activities that strengthen and refresh me rather than trying to escape. Spiritual Formation - I actively welcome God into my home, set a godly example and encourage the faith of my family members. Personal Development - I strive to learn new things and deepen my current pool of knowledge, encouraging my family to do the same. Health - I have a healthy lifestyle in regard to diet, exercise, grooming and cleanliness without an excessive preoccupation with them. Hospitality - I welcome people to my home, using the opportunity to strengthen and encourage them in life’s journey.
Relationships	Social Network - I have a solid group of friends who keep me accountable, encourage me and strengthen my relationship with God. Relatives - all my relationships with my extened family and in-laws are vibrant and healthy. I enjoy spending time with them. Tolerance - I have strong relationships with people who are quite different than me, and I do not wrestle with bias or bigotry of any kind. Being Mentored - There are several people more experienced than me who personally influence my life on a regular basis. Mentoring Others - I have a positive, personal influence on the lives of several people with less experience than me. Compassion - I am generous with and quick to respond to the needs of my friends and family without expecting anything IN return. Receiving Criticism - I like to be challenged by my peers and am willing to accept criticism without lashing out or harboring bitterness. Forgiveness - when I am hurt or offended, I am quick to confront the responsible person in love and do not speak ill of them to others.
Industry	Education - I am well-educated with regard to my work and I am continually learning and applying new information as it develops. Gifts match - my work is a perfect match with my areas of giftedness. What I do for a living comes rather natural for me. Contribution - I thoroughly enjoy serving the people who benefit from the results of my labor. My work is a tremendous blessing to others. Employee Relations - I have terrific relationships with everyone I work with regardless of their position. We are a team. Empowerment - Whenever things are not going right, I am able to influence positive change without offending or ostracizing others. Goals - I am motivated by compelling, realistic goals that stretch my abilities and challenge me to work with excellence. Time Management - I work with diligence, completing my tasks in a timely manner, yet leaving sufficient time for other priorities in life. Enjoyment - My work brings me satisfaction and enjoyment. I can not think of anything else I would rather be doing.
Society	Respect - I am respected and well-liked by people in the community who know me. They like to spend time with me. Neighbors - I know my immediate neighbors by name and have a good relationship with them. We enjoy living on the same street. Civic Duties - I gladly fulfill my civic duties (i.e. voting, jury duty, paying taxes, school involvement) when I am called upon to do so. Peacemaker - I am a peacemaker. I do not engage in conversation or behavior that denigrates people of other races, religions or cultures. Charitable - when I see an individual or family in need, I am quick to give of my time and my resources to bless them. Law Abiding - I am an exemplary citizen, refusing TO engage IN ANY kind of behavior that could get me IN trouble WITH the law. Positive Influence - I associate WITH several groups of people IN the community AND have a strong, positive influence IN their lives. Cultural Awareness - I spend time with diverse groups of people and have a good understanding of their various cultures and philosophies.
Talents	Discovery - I know what my various gifts and talents are and I am often encouraged by others to use them. Stewardship - I freely use my talents and abilities for the benefit of others without expecting anything in return. Practice - I regularly spend time sharpening my abilities and strengthening my skills so that I might perform with excellence. Teachable - I continually seek out others who are more proficient than I am in order to learn from them and improve my talents. Teaching Others - I can often be found helping others develop their gifts and talents and encouraging them to use them. Cooperative - Whenever I use my talents and abilities in conjunction with other people, I am a team player. I am often asked back. Humble - I am not overly concerned with receiving credit for my contributions, and I am content when others surpass my abilities. Confident - when called upon to use my talents, I am confident that I can get the job done. I enjoy a good challenge.

4. Other important information!

Have you met with a Flatland Life Coach before?	No Yes
Would you like to request a specific Life Coach?	No Yes
If yes, please specify.
Do you currently attend Flatland?	Yes No Less than 1 year Yes - 1-5 Years Yes - More than 5 years
If you do not attend Flatland, do you listen to our podcast?	Yes No
Where are you at in your spiritual journey?	Exploring Christianity New Believer Clost to Christ Christ Centered