Mama Bear Mentorship Application Form

Mama Bear Mentorship Application Form

As an exclusive mentorship programme, with limited spaces Mama Bear Mentorship programmes have an application process. This is to see if we are compatible to work together and to be sure I have the skills and experience to support you on your path. Please answer honestly and with enough detail I can understand your persepective.
Name*

First NameLast Name
Call me...
Tell me what name you like to be called.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number this will be used for regular contact, make it relevant.
Email*
example@example.com
What is your Date of Birth?

MonthDayYear
Date
How do you identify your gender? I am a...

WomanManNon-Binary or IntersexTrans-womanTrans-manOther
When considering your life path, where are you?
What is your current circumstance? Use your own words...
When considering your life path, where do you want to be?
What is your dream life or ultimate goal for yourself?
What do you see as the main problems or blocks that stop you from creating or fully expressing yourself?
Use your own words to describe what you feel holds you back?
Have you tried any healing modalities in the past?
This can be brief I am trying to understand how you move through life currently.

Tell me currently how you feel about...*

	Not Satisfied	Somewhat Satisfied	Satisfied	Very Satisfied
Your physical health
Your mental health
Your spritual experience
Your social life
Your close relationships
Your work life
Your home

Have you ever experinced any trauma, abuse or neglect?

NoI don't knowChildhood Sexual AbuseChildhood Domestic Abuse (by a Parent or Guardian)Childhood Neglect (Emotional or Physical)Domestic Abuse (By Partner or Spouse)Adult Violence (incuding Rape or Assault)War or CombatAccident or Physical InjuryOther
When would you like to begin your mentorship programme?*

NowIn the next few weeksNext monthLater this year

If you are suitbable for the programme I need to know when you prefer to connect. Please select when you are most often, likely able to connect in UK time.

	Afternoon 12-4pm	Evening 4-8pm
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Payment Options
Mama Bear 6 month Programmes are priced at £6,000.

Applicants can also choose to pay up front or in installments. Installments can either be:
- Three (bi-monthly) or
- Six (monthly) payments.
Payments are always required before the next session once accepted to the programme.

Your preferred payment options will be set up with your personalised programme and details will be confirmed via your approval email.

Your choice of payment does not effect wether you are chosen for the programme.

*Mama Bear Terms & Conditons apply.
Choose how many installments you would like to make

One upfront paymentThree bi-monthly paymentsSix monthly payments
Choose how you prefer to pay.

Stripe via web processing platformPayPalBank Transfer or BACSOther
Thank you for answering and sharing your experince and goals with me. It is a big step and I appreciate you trusting me.

This information will be kept private, never shared nor used for purposes beyond our mentorship relationship.

A one to one call or zoom session will be required to go over your application and welcome you to the programme if feel I can support you at this time.

Once we connect and a payment is made an agreement will be sent and details of the mentorship will be confirmed and relational boundaires agreed.

Your personalised programme will be confirmed & our sessions will begin at a mutually agreable time.

I will respond via email to let you know how we will progress within the next 7 days.

I can be contacted at connect@snowdropssunsets.com or mail@loveschool.uk
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Mama Bear Mentorship Application Form

Payment Options