Authentic Woman Membership Application Form

MEMBERSHIP APPLICATION FORM

INSPIRING YOU WITH COURAGE TO TRANSFORM & CREATE THE LIFE YOU REALLY WANT.
Name*

First NameLast Name
E-mail*
Phone Number:*

Area CodePhone Number
Address:*

Street Address

Street Address Line 2

CityCounty

Post CodeCountry
Year of Birth*
Day and Month of Birth (eg 14th June)
Occupation
Where did you hear about us?

A Friend or colleaugeGoogleEventbriteFacebookInstagramOther
What are you hoping to gain from this membership?
MEMBERSHIP INCLUDES
- Workshop Online – Once a month
- MEMBERS ONLY WhatsApp Encouragement & Support Group.
- Private Facebook Group
- Monthly Newsletter
- 25% Discount on Life & Business Hub
- 20% Discount on Andrea Graham Exclusive Jewellery Collection
- Membership rates for In-person Workshop and Events
- Membership Discount rates for 1-2-1 Private Coaching services
[Authentic Woman reserves the right to make changes.]
IMPORTANT: FREE MEMBERSHIP! - Membership is currently FREE (Valid Until 10th July 2022 there is nothing to pay to join.

To start your membership please pay £27.97 to: Starling Bank; Account Name Andrea A Graham Ltd; Sort Code 60-83-71; Account No. 16745925. Thereafter please pay £27.97 per month via Bank Standing Order (to the same account) to be paid on the 1st of each month. Please state your name as the reference. Thank you.
Privacy Policy*

I have read, understood, and accepted the PRIVACY POLICY for membership.
Once you submit your Registration for Membership and have made your initial membership payment of £27.97 we will contact you withinin 48 hours.

Thank you!
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MEMBERSHIP APPLICATION FORM

IMPORTANT: FREE MEMBERSHIP! - Membership is currently FREE (Valid Until 10th July 2022 there is nothing to pay to join.