44 MIDLOTHIAN AVENUE

EASTLEA LIFE ISSUES COACHING

HARARE
+263 7 18831695 WITH FGK
fgklifeissues@gmail.com www.fgklifeissues.co.zw

Life Issues with FGK Coaching form

PERSONAL DETAILS

Faith Mutsawashe Maponde

FULL-NAME: ………………………………………………………………..

Female
SEX: ………………………….. 16.10.08
DATE OF BIRTH: …………………….

MARITAL STATUS:Not married

…………………………………

PREFERRED TITLE: MR/MRS/MS/DR./Professor/other (specify):…………………..

BOOKING DATE:………………………………………..
(kindly note all bookings are made upon payment)

14 Woodgate,Mt Pleasant
PHYSICAL ADDRESS: ………………………………………………………………..
………………………………………………………………..…………………………..

0777725888/0780649171
CONTACT NUMBERS: ………………………………………………………………..

Email Address: faithmaponde85@gmail.com

………………………………………………………………………….

COACHING AND COUNSELING DETAILS

SESSION DETAILS:

1. Becoming [ ] Adolescent Girl Child Grooming [ ] Purpose [ ] Special Ethical Issues [ ]

2. Individual [ ] Group [ ]

3. No. of Sessions:

a. Once-1 hr $50 [ ]
b. (I) Whole Program- 5 hrs $250 [ ] (II) Whole Program (Girls) [ ]
c. Group Session- (I) 1 Day - 4 hours $30pp [ ] (II) 3Days- 3 hours/day [ ] $25pp/day
III 5 Days – 3 hours/day [ ] $20pp/day

LIFE ISSUES COACHING WITH FGK

44 MIDLOTHIAN AVENUE
EASTLEA LIFE ISSUES COACHING
HARARE
+263 7 18831695 WITH FGK
fgklifeissues@gmail.com www.fgklifeissues.co.zw

4. Type of Session: Physical [ ] Virtual [ ]

5. Coaching and Grooming Areas of concern:
a. Issues of Life [ ]
b. Relationships [ ]
c. Becoming [ ] you
d. Workplace [ ]
e. Marriage [ ]
f. Ethics and Etiquette [ ]
g. Confidence and boldness [ ]
h. Career [ ]
i. Grooming [ ]
j. Other (specify) …………………………………………… [ ]

6. Special Ethical Issues Areas:

a. Issues of Life
b. Family
c. Marriage
d. Progress
e. Workplace
f. Other relationships
g. Other (specify) ……………………………………………

7. Method of Payment:
a. Cash at the Offices [ ]
b. Bank Deposit [ ]
c. PayPal [ ]

PRINT FULL NAME: ……………………………………………………

SIGNATURE: …………………………………………………….

LIFE ISSUES COACHING WITH FGK