Your roadmap to finding out who you are, discovering what you want, and living the great life you were born to live
ADMISSION FORM (v0.2 beta)
Welcome and thank your for your interest!

The Life Bootstrapping System is not just a suite of consecutive coaching sessions. It is a truly powerful "resetting" system, the purpose of which is to bring you on the best track for your new life. It is a little bit more intense than traditional coaching sessions because you have to go deep inside yourself to provide a lot of information in a short time. Then this information is processed and compiled in a way that should make sense to you, in order to create clear goals and a roadmap to reach them.

The program is by invitation only so I can carefully take care of each participant.

As I involve myself deeply in the process and am entirely concerned in providing results to my clients, I have to limit entry to the programme only to those who are serious and fully motivated and committed to succeed.

The decision leading to an invitation in the programme is entirely based upon those motivation and commitment criteria. We do not base our decision upon any discriminatory factors such as race, gender, religion, wealth, etc.

Everybody is most welcome to join and I am honoured to have helped many happy and successful members change their life in every corner of the World.

In order to make sure we are a good fit for each other, I would be grateful if you could fill-in this Admission Form. It should take you approximately 10 minutes to complete.

You can access the program tour overview here, should you need more information:

Hi, it’s really nice to meet you! Before we proceed, I need to know a little bit more about you.

If you have any questions, just ask me here:
First Name *

Last Name *

Birth Date *

This information is important for the programme.
Please use the following format: "12 November 1977"
Gender *

Professional Occupation *

What do you currently do for a living?
Years of Professional Experience *

Dream Job *

If money was not a criterion or an issue, what would you dream to do for a living? If you have no idea (yet!), just type "no idea".
Studies Major/Topics *

What is your main field of study? What is your specialty or main qualification?
Other Qualifications or Certifications


Optional: please type your LinkedIn address (link) below, if applicable:

Optional: please type your Facebook address (link) below, if applicable:
Other Social Network (Google+, Twitter...)

Optional: please type your any other social network you would like to share (link) below:
Picture of You *

This step is uber-important! Please provide the nicest picture you have of yourself, preferably one where you are alone on the picture. Ideally, the picture should be a portrait clearly show your face and be of a high resolution.

Of course, I respect your privacy and this image will be used solely for the purpose of the LBS Programme.

Ok, now I would like to know a bit about your past experience with coaching. This section is important, as it will have an impact on the customisation of your programme.
1. Have you already participated in a coaching programme in the past? *

How satisfied were you of this experience? (Please explain)

Please explain.
What was the format of the coaching programme?

2. In the past 6 months, have you already taken a personality assessment? *

Have you taken such personality assessment with one of the following instrument?

3. In the past 6 months, have you taken another type of test or instrument for the purpose of evaluating your strengths, your entrepreneurial capacities, your emotional intelligence, etc.? *

What was the name of the test(s)/instrument(s) taken?


This section is optional. If you are committed to make a change in your life and ready to make things happen now, then the LBS Sponsorship might be for you. Every month, we offer “sponsorships” to a few motivated, passionate, and determined mentees who are serious and committed to make a change in their life.

Results are so much more impressive and quick to come when one is truly committed to accomplish the required changes to have a great life. As an incentive to commit to success, if you think you have what it takes to get the most out of this programme and are ready to prove it, then you may be eligible for the LBS Sponsorship.

The LBS Sponsorship consists in a 50% contribution to the full price of the mentorship programme. Eligible mentees will receive additional support in the form of a special follow up in implementing their Action Roadmap and will be assessed on their results at the end of a 6 months period.

To be eligible for the sponsorship, you must agree to comply with some requirements (details next page) and provide a short letter of motivation explaining why you think you deserve such sponsorship.
Do you want to apply for the LBS Sponsorship? *

"Yes, I would like to apply to the LBS Sponsorship and provide herewith my Letter of Motivation. If I am selected, I hereby commit to fully comply with the requirements and conditions of the LBS Sponsorship." *

Basic Requirements for the Sponsorship:
- You shall be committed to make a change in your life now
- You shall accomplish all the exercises of the programme within the prescribed timeframe
- You shall commit to not abandon the programme in the middle
- You agree to pay the reduced price in full at the beginning of the programme
- You agree to provide a testimony of your experience and success at the end of the programme

Please type your Letter of Motivation below:

The answers to the questions below will help me in better crafting your personal experience in the programme. Please answer the following questions with your first, from-the- gut response:
1. Are you capable of becoming passionately excited about a wide variety of subjects? *

2. Do you have a hard time choosing between one interest and another? *

3. Do you find yourself interrupting yourself, dropping one task to pick up another before it’s done? *

4. When you really understand how something works, or master a new activity, do you feel bored and ready to try something new? *

5. When you were a child, did you have many answers to the question “What do you want to be when you grow up?” *

6. Do friends and co-workers seek out your opinion on a variety of topics (even outside your field) because they like the way you see connections between apparently unrelated subjects? *

7. When you come up with an idea, do you prefer to delegate or hire out the tasks of turning that idea into a reality? *

8. Do you ever describe yourself as a “dabbler” or a “dilettante”? *

9. Are bookstores and libraries like candy stores to you, places where wonderful and intriguing items are on display at every turn? *

10. Do you find it almost impossible to answer the question “What do you picture yourself doing in five years?” *

11. Do friends suggest that you become a contestant on game shows because you know “something about everything”? *

12. Do people say that they enjoy talking to you because of your enthusiasm for their plans and activities? *

13. Are you sceptical of traditional time-management and business tools, such as long-range plans or detailed schedules? *

14. If you went to college, did you look for interdisciplinary or multiple majors? *

15. If you specialized in a particular subject in school, did you move into a new field after your education was complete? *

16. Are you competent—even highly successful—at your job but feel there’s something else you’d rather be doing, even if you’re not sure what? *

17. After a year or two of doing something, do you feel the itch to move on to something else? *

18. Do family members offer this kind of advice: “You ought to settle down and get known in one field, rather than switching from one career to another”? *

19. When friends or family members describe you to others, do they often say, “Oh, ______ just hasn’t settled down yet. ______ is always trying something different. I wish ______ would just figure out something s/he’s interested in and stick to it!” *

20. Do you distrust your own decision-making ability be- cause you “definitely knew” you wanted to be an X, and then you “definitely knew” you wanted to be a Y, and then you “definitely knew” you wanted to be a Z, and then...? *

One last thing: your home address

At the end of the program, you will receive your own personalised Life Bootstrapping System Book. To do so, I will need your home address, or any other address at which you want me to send it to.

Please type in you address in the following format: Street Name, Nr. - Postal Code, City - Country

(Don't forget to specify your country and any other directions such as box Nr. or floors!)
You did it! That was the last question!

Before you go: How would you rate this form?

Awesome {{answer_3180601}}, you did it!
I shall now review your data, prepare a tailored offer based on your inputs and, if you accept it, we shall get going asap!
You: "Hey Captain, I’m ready to have my life bootstrapped! When do we start, Aye?"
Me: "Ok, 1-2 business days and I’ll send you everything you need to kickstart your Journey. We shall then get going without further ado. It’s gonna be amazing, you’ll see!"
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