The Mindset Lab Registration Form

First name

Last name

Birthday

Day

Month

Year

Email

Phone

What made you want to join this program?

What best describes your current situation at work?

Which patterns do you notice showing up for you at work?

Overthinking decisions or conversations

Saying yes too quickly / weak boundaries

Feeling stuck or unsure of my next step

Taking on too much responsibility

Feeling confident but emotionally drained

Other

What are you hoping to gain from joining Mindset Lab program?

This is a 6-week group coaching program running every Tuesday at 8 PM UAE time. It requires reflection, honesty, and active participation. Are you willing to commit to the full journey?

Yes, I am committed

I am committed but I need flexibility

Please confirm: (Checkboxes - all required)

I understand this is a coaching-based reflection program, not therapy or training.

I’ve read and agree to the Group Coaching Agreement (can be viewed on the website - desktop only)

I consent to participate in this coaching program and allow my anonymized data to be used for ICF credentialing logs, in line with the Coaching Agreement.

I understand that after submitting this form, I will be redirected to secure checkout to complete my registration.

The regular investment is 2000 AED.

An early bird rate of 500 AED is available using the code MINDSET at checkout.

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