Expert Signup Form

Empath Mama Collective Expert Form

Thank you for your interest in supporting our community with your expertise. First step is to complete this form. This is not an application it is a form to get to know you and your business. We will contact you within 48 hours to discuss this form and further details. Thank you for your interest in being one of our Experts.
Name *

First Name Last Name
E-mail *
Business Name *
Website *
Describe your business (services you provide) *
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Do you understand the terms Highly Sensitive Person (HSP) and Empath? *

Yes No Not sure
Social Links
Short Bio *
Which level are you interested in? *

Free - ready to see how you can make a difference Paid - you are ready to jump in as an expert and grow your business and connections ($147 annually or $13 monthly) Not sure at this time. I want to learn more.
Describe a workshop that you have taught in the past or that you would like to teach for the Empath Mama Community.
Why Would you like to be apart of the Empath Mama Community? *
How big is your audience? List each: Email size + any social media channels that you regularly use. This gives us an idea of your reach. Don't worry about your numbers, this is not a deciding point.
Do you agree to share your events or workshops with your community? At least one email and one social posts. This is for the Pro and Elite experts. *

Yes No
I consent to have Empath Mama collect and store my information via this form for the purpose of my participation in the "Empath Mama Community".
Signature:

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Empath Mama Collective Expert Form