SCA: Enrollment Questionnaire

Thank you for your interest in one or more of the masterminds, cohorts, workshops or other programs (collectively “Programs“) led or hosted by Segal Coaching LLC.

Please complete and submit the following questionnaire if you are interested in in joining one or more of our Programs. As soon as we review your questionnaire and determine you are a match, assuming there is space available in the Program, you will be pre-cleared to enroll .

While you only need to sign one Universal Terms & Conditions, a new enrollment questionnaire is required to join each Program.

If you don’t already have a Universal Terms & Conditions (“UT&C“) on file, you will also need to execute a UT&C to confirm your enrollment.

As of March 7, 2023, a signed UT&C is a requirement for each participant prior to the start any of Program commencing on or after that date, as it includes confidentiality and other significant provisions.

If you have any questions or concerns, please email us at

Note: If you do not give consent to personal information being stored by Segal Coaching LLC, please do not complete a submission. For a copy of Segal Coaching LLC’s privacy policy, click here. Your answers will be kept confidential in accordance with the ICF Code of Ethics.