The Empowered Woman Application

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Are You Ready to Unleash The Empowered Woman Within? .* This field is required.This application will take 1 minute of your time, its mostly all multiple choice!
I am just starting my healing journey. I want to break-free of limiting beliefs, heal trauma, and discover my passions.
I am have been on the healing path. I am in touch with my passions. I want to go deeper, so I can be confident and align with my purpose.
I am deep on the healing path. I know my passions and purpose. I want to advance my career, make a shift, or align more with my leadership & legacy.
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What's Your Name?* This field is required.
Enter Your First Name Here
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What's Your Email?* This field is required.In a few minutes, we'll send your legit email and your application
example@example.com
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What's Your Phone?* This field is required.In a few minutes, we'll send your legit email and your application
example@example.com
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Where are you in your healing journey as relates to understanding your childhood and traumas?* This field is required.
I am just awakening and discovering that I have a painful past that I need to deal with
I recognize that my traumas of the past need healing and are creating patterns in my life
I've been working on my past, but I'm not able to break the patterns and cycles with the current ways I've addressed it so far
I'm ready and willing for alternative methodologies beyond or in conjunction with therapy.
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Passions: How connected are you to what you love doing and what you desire to express in your life?* This field is required.
I am not connected to my passions
I have moments where I feel into my passions
I practice expressing myself through my passions
I fully express and live my passions
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Authentic Self: how connected are you to being yourself, expressing yourself freely and aligned with your needs and desires?
I feel disconnected and unable to express myself authentically
I have moments when I'm being authentic
I am being authentic in most of my life
I am fully authentic in all areas of my life
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Confidence- How would you rate your levels of Confidence?* This field is required.
Im trying but I still doubt myself.
I do my best but I have my off days.
I am disciplined and self-motivated.
I have 100% self-belief and self-empowerment to achieve ANYTHING.
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Improved Communication & Relationships: How do you feel you communicate and do you foster healthy relationships?
I am not a good communicator. I end up in toxic relationships.
I have had many bad relationships, but I am learning my patterns and how to communicate more effectively and with less reactivity or defensiveness.
I have worked on ways to communicate and my relationships are improving. I can keep calm and recognize how to take personal responsibility.
I have done a great deal on communication, plus shadow work. Now I am consciously aware most of the time on how to be vulnerable, take personal responsibility and show up with understanding and compassion.
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Alignment with Purpose. Are you aligned with your purpose?
I am still trying to find my purpose
I have some sense of my purpose, but I am still unable to understand how to align to it
I am working on projects that are aligned with my purpose, but I have not yet fully committed to it and there are barriers in the way
I am living my purpose and ready to make a bigger impact
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Business/Career: Please rate where you are on your journey.* This field is required.
1- I have no intention to become an entrepreneur. I have a job and business that I love and I"m passionate about. I would do this program for self-healing only.
2 - I have fears around becoming an entrepreneur (scarcity, money, success, failure, rejection, imposter syndrome, perfectionism, etc)
3 - I am interested in creating a shift in my life to leave my job
4 - I have an entrepreneurial business or job that I love and I'm looking to up-level grow and make a bigger impact!
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Have you ever received coaching, mentorship, or been in therapy?* This field is required.Please let us know if you are currently in therapy, or what type of coaching you have done.
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WHAT'S your vision that you want to manifest in the next 3-6 months?* This field is required.In 3-6 months time what would you like to manifest? Who would you like to become? You can include things such as Health, Wealth, Relationships, Career, Business, Spirituality, Goals, Travel, Passions etc. - Be as detailed as you want, don't worry if you don't fully understand what you want yet, as we will be able to expand and develop your vision more later on.
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How committed are you with investing in yourself?* This field is required.
1 = Not committed
2= I'm one foot in, one foot out. I'll keep doing the same as today.
3 = Mostly committed. I need some accountability and mindset shifts.
4 = I'll do whatever it takes to make this happen. I'll invest time, energy & resources to becoming the best version of myself and manifesting my visions into reality.
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How did you hear about this program? Did anyone refer you?
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