Application for Private Mentorship & On-Site Immersion (add-on)

Full Name *

Email *

Confirm Email

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Have you already been accepted for the 8-Month Exclusive Private Mentoring?

What do you apply for?

8-Month Exclusive Private Mentoring
On-Site Immersive Add-On (Requires 8-Month Exclusive Private Mentoring)
Both

Preferred Contact Method *

WhatsApp / Email / Phone

How did you hear about this private mentorship? *

Referral / Returning Client / Social / Website / Podcast / Other → If Other, show short text

Starting Month

When would you like to begin your 8-Month Private Mentorship

What draws you to this mentorship now? *

Top 3 outcomes you want to create in the next 8 months *

What has held you back so far? *

Have you previously worked with a coach/therapist/mentor? What worked or didn’t? *

What would make this a “10/10” experience for you? *

Readiness to commit *

Scale 1–10: 1 equals "Not at all"; 10 equals "Can`t wait"

Weekly time you can reliably allocate *

45-min session / 15–30 min daily practice / 1–2 hrs weekend reflection

Accountability partner *

I have one / I want guidance to choose / I prefer to rely on Stefan only

WhatsApp availability

Comfortable with brief check-ins / Prefer low-frequency / Prefer voice notes

Current mental/physical health considerations *

This mentorship is not, and does not replace medical or psychiatric treatment

Are you also applying for the in-person On-Site Immersion (add-on)? *

Yes / Not now

If Yes, A. Preferred timing *

How often, which duratin (2,3,5 days) and Start / Midpoint / Closing

If Yes, B. Location *

city/country

If Yes, C. Do you agree to arrange and cover travel & accommodation *

Yes, No

Anything else I should know to tailor the experience to you?

Program Understandings *

I understand this is a private mentorship (not medical/psychiatric treatment)
I understand the commitment is 8 months with weekly sessions and practices
I understand availability is limited and my application may be declined

GDPR Agreement *

I have read and I consent to the storage and processing of my data for the purpose of assessing my application.

I have read and I agree to the Privacy Policy

Signature How commit

Terms Private Mentoring *

I have read and I agree to the Terms of the 8-month Exclusive Private Mentoring Program

Special Terms & Conditions

Terms On-Site *

I have read and I agree to the Terms of the On-Site Immersion Add-On

Terms On-Site Immersion Add-On

Signature *

Clear Signature

Please enter your full Name

Your Application for 8-Month Private Mentorship and On-Site Immersion (add-on)