Worthy Women Rise Application

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Name* This field is required.
First Name
Last Name
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Birth Date* This field is required.
Month
Day
Year
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E-mail* This field is required.
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Street Address
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City
State / Province
Postal / Zip Code
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Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
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Guadeloupe
Guam
Guatemala
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Guinea
Guinea-Bissau
Guyana
Haiti
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Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Occupation* This field is required.
6
How did you hear about Worthy Women Rise?* This field is required.
Facebook
Instagram
RECLAIM podcast
Referral from friend
Google search
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Tell me a little about yourself.* This field is required.
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Why are you applying to join Worthy Women Rise?* This field is required.
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What would you like to get out of this program?* This field is required.
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What is your biggest struggle in your life right now?* This field is required.
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What would you like to say you were able to do because of Worthy Women Rise?* This field is required.
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Tell me a little bit about your financial situation.* This field is required.Give me an idea for why you are seeking sliding scale option.
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What component of Worthy Women Rise are you most excited about?* This field is required.You can select more than one.
Thais' teachings
The community element
The group coaching calls
The homework/assignments
Other
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Do you have any fears, worries, or trepidations about this program? Share them with me here:* This field is required.
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If accepted, will you be fully committed to doing the work in this program and showing up on the calls?* This field is required.Worthy Women Rise is an intimate group where your participation, in whatever way feels right for you, is a critical component of the work. By checking yes below, you affirm that you will show up to the best of your abilities and prioritize this work. This includes the weekly calls at 530pm PT every Wednesday.
YES
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Please note - this program is not therapy nor a replacement for therapy.* This field is required.Getting the right type of help is important. By checking below you are agreeing that you are not using this program to replace mental health treatment, though you are welcome to do this alongside therapy. Should any mental health challenges arise, you agree to notify Thaís so that the two of you can create a plan together.
I UNDERSTAND
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What level of investment feels right for you?* This field is required.When thinking about this question, it's helpful to think about both what is sustainable for you as well as what feels expansive and slightly uncomfortable for you. Keep in mind that regular price for this program is $367/month for 12 months.
$150/month
$175/month
$200/month
$225/month
$250/month
$275/month
$300/month
$325/month
Other
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Anything else you would like for me to know?Once you click submit, your application will be processed and you will be notified of next steps by Feb 24th 9pm PT at the latest.
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Application FeeNOTE: In order to submit your application, a $150 security deposit is required. If you're accepted into the program, your $150 deposit will be rolled into your first payment. If we ultimately decide WWR is not the right fit for you, your deposit will be refunded.
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