Coaching Form

Thank you for purchasing coaching from Work-At-Home Success! Please note that your credit card will show “ClickBank/Keynetics” as the merchant for this purchase. If you purchased Package C (4 sessions a month for 6 months) please note that you’ll be billed $140 for your initial month, and you’ll automatically be billed $140 a month for the next five months. All other packages (A and B) involve just a one time payment.

Please fill in the information below to schedule your coaching session. If you have any questions, please contact me.

Please note that if you need to cancel your session, you need to provide Leslie with 24 hours notice if you want to reschedule. If you’re not at the number provided when Leslie calls on your appointed time, your session will still be considered fulfilled.

Please provide the following contact information. Provide several day and times to contact you in the “Contact Day/Time” Field. I’ll email you to set a specific apppointment.:

Name
Phone
E-mail
Contact Day/Times

To make the most of your coaching session(s) please fill in the information below.

What is your goal for the coaching session (what do you hope to learn or get out of the meeting)?

What questions would you like to ask?



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