The Confidence Mastermind Application - NOTE: YOU MUST FILL OUT THE ENTIRE FORM OTHERWISE YOUR INTERVIEW WILL BE CANCELED. Please Answer ALL Questions in Detail)
SocialExpression.NET - David Hamilton, Confidence Coach
(PLEASE NOTE: The Information sent via this Form is SECURE)

NOTE: TO APPLY FOR AN INTERVIEW YOU MUST BE...

1) Willing to take action to have what you want and ready for massive positive change
2) A man who is 27 or older
3) Be in the US or Canada and have Tuesday evenings open twice a month
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First Name *
Last Name *
Email Address *
What is your Age? *
CHALLENGES: What are your biggest challenges in terms of your self-confidence, and how do you think it affects your success? *
DESIRES: List everything you want in terms of your social life (work/career, social circles/networks, dating/relationships, etc) *
COST: What is not having the social and self-confidence issues costing you? *
CURRENT: What is your current social life like? What do you feel is missing? *
HELP: What have you done so far to help yourself overcome your shyness and build your self-confidence? Please list anything free - or paid products, programs, therapy or coaching that you invested in *
On a scale of 1-10 how WILLING OR COMMITTED are you to becoming the most confident and successful man you can be? *
(NOTE: this question isn't about if you think you can do it or not, but rather how committed you are, how willing and how much you want it)
Not Committed
Highly Committed
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