Discovery Session Request Form

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Please complete all questions in the form in order to submit your request for a discovery session.
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Name* This field is required.Please provide your name or how you would to be referred to as.
First Name
Last Name
3
Phone Number* This field is required.Please provide your most reliable contact number
4
SMS Utilization* This field is required.Are you able to receive text messages (SMS) on the phone number you provided?
Yes
No
5
Email* This field is required.Please provide your email address.
example@example.com
6
Ethnicity* This field is required.Please select which ethnic group(s) you belong to.
Black/African-American
Caucasian
Native American
Asian/Pacific Islander
Latin American/Hispanic
7
Generation* This field is required.Based on your birth year, select which generation you belong to.
Alpha (2011 & Up)
GenZ (1995-2012)
Millennial (1980-1994)
Gen X (1965-1979)
Baby Boomer (1946-1964)
Silent (1925-1945)
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Which Service(s) Are You Interested in Learning More About?* This field is required.Select which coaching service(s) you are interested in.
Podcasting/Content Creation
International Travel/Relocation
Personal Finance & Debt Freedom Coaching
Private or Group Tutoring
E-Learning Coaching and Course Creation
9
Select the Industry That You Currently Work In?* This field is required.Which industry do you currently work in?
Advertising/Marketing
Arts and Design
Broadcast Media & Publishing
Business Support & Logistics
Construction & Machinery
Consulting
Education
Food & Beverage
Government Services
Healthcare
Insurance
Law Enforcement
Non-profit
Real Estate
Technology
Telecommunications
Other
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Additional Details About You* This field is required.Please give us 1-2 goals explaining what you are hoping to achieve through your discovery session.
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Discovery Session Consultation Fee
prevnext( X )
My Bag
1
My Bag
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
ORDER SUMMARY
Total costUSD
NON-Refundable Session FeeConsultation Fee is for serious inquiries only
$50.00Edit
Back
Total cost $0.00
Payment Methods
Credit Card
First Name
Last Name
Cash App
After submitting the form, you will be redirected to the Cash App Pay to complete the payment process.
Apple Pay
After submitting the form, you will be redirected to the Apple Pay to complete the payment.
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Thank You for your interest in Smart Jewelz Enterprises {name}!

Your submission has been received! We look forward to partnering with you and/or your business. Now that you've taken the first step, please schedule your Discovery Session on the next page. An SJE representative will review your request and contact you within 24-72 hours to confirm the booking details.

Keep Shining Bright Like the Bright Diamond Jewel You Were Created To Be!

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