Leaders of Impact Application

Thank you for your interest in Leaders of Impact! This application helps us understand your goals, challenges, and how we can best support you in this journey. Please take a few minutes to fill it out thoughtfully!

✍️ Complete the online application & Schedule your interview (~15 minutes)

This is to get to know you and your learning goals better
This is also where you’ll be selecting your payment plan

📞 Interview with Jiggy (45-60 minutes)

We will review your application and address any questions you may have
If we’re a great fit for each other, you’ll receive your invitation to join the program during this call
To complete your registration, you’ll confirm your enrollment by e-signing the agreement and submitting your first payment during this call

🥳 Clear your schedule! Our time together begins Sunday, April 6th, 2025

Name

First Name

Last Name

Pronouns

Social Media / LinkedIn

http://

Current role / position

How did you hear about the program?

What brings you here?

What made you say ‘yes’ to exploring this program? What specifically drew you in?

How would you describe your leadership and communication skills today?

Are there any challenges you’re currently facing?

How would you describe your personal relationships, impact, connection, and/or quality of life today?

Are there any challenges you're currently facing?

Have you tried any programs, books, or coaching before? If so, what worked and what didn’t?

What specific skills or growth areas are you hoping to develop in this program?

If you could walk away from this program with ONE transformational shift in your leadership and personal transformation, what would it be?

What obstacles might get in the way of your learning or participation in this program?

(ie. Time constraints, self-doubt, lack of community support, financial concerns, etc.)

As with any nature of a growth journey, this program will challenge and stretch you. How do you plan to show up for yourself and your cohort, even when it gets uncomfortable?

What qualities do you look for in a mentor or coach, and how do you see me supporting your growth?

Which payment plan would you prefer?

This will be the payment structure outlined in your invoice, due upon completion of the interview and acceptance into the program.

One-Time Payment ($2,250)

3-Month Plan ($775/month)

5-Month Plan ($465/month)

Is there anything else you want me to know about you and your journey?

Any questions for me?