Last Love Blueprint Call Application

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Name* This field is required.
First Name
Last Name
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How did you arrive at this application?* This field is required.
from webinar
email
social media post
messenger/other
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Email* This field is required.
example@example.com
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Do you have a US-based mobile phone?* This field is required.
YESNO
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Please enter your MOBILE (Cell) Phone Number Here.* This field is required.
Please enter a valid phone number.
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IMPORTANT: If your application is accepted, you will be redirected to a scheduling page, to choose an available time on our calendar, within the next three days. Once you are scheduled, are you able to schedule and set aside approximately 90 minutes of quiet, uninterrupted time to get the most out of this call?* This field is required.
YESNO
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Please provide your facebook profile link here (This is optional, but can help us get to know each other better. If you don't mind, please copy and paste the link in your browser when you are on your own profile page.) If you can't or don't want to do this, you can just type "NA" below.* This field is required.
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What is your age?* This field is required.
Under 40
40-59
60-79
80 or over
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What is the primary reason you are booking this call?* This field is required.Please pick the one that is CLOSEST to accurate for you. (I understand there might not be a "perfect" answer.)
I am tired of being single and picking the wrong men, so I really need help finding love, and I want to learn more about how you can help me.
I want help with a current relationship.
I'm just curious about what you have to say.
It's free, so why not?
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IF you answered that you want help with a current relationship or situationship... What is the goal you are wanting help with?* This field is required.Pick the choice that best describes your goal
I am not happy and I want to find the strength to end this relationship and learn how to choose and attract better in the future.
I want to figure out if this relationship can be saved, but I am open to ending it, and I want to learn how to choose and attract better in the future.
I really want to save this specific relationship and am not open to ending it any time in the near future.
I am NOT in any current relationship.
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What was it about my presentation, ad, and/or post that you liked the most, or that resonated the most with you?* This field is required.
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Tell me a little about yourself, so we can get to know each other better.* This field is required.(i.e., your age, what kind of work do you do... do you have kids, what are your hobbies, passions, goals/dreams... whatever you feel comfortable sharing)
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How long have you been single?* This field is required.Please note: For this purpose, "single" simply means "not in a romantic relationship."
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Tell me a little about your love history.* This field is required.(i.e., what kinds of issues / failures / successes have you had in dating and relationships, what kinds of men do you usually attract / choose)
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What is the most frustrating part for you of NOT having the loving relationship you want in your life?* This field is required.
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Please describe what you are looking for in a partner and relationship.* This field is required.
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What have you already tried to find love? (select all that apply)* This field is required.
Online dating
Matchmaker
Dating coach
Meeting men the "old fashioned" way (out at bars, through friends, at church, etc.)
Law of Attraction/Manifesting
Not much. Just hoping it will happen when I'm not looking.
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What are your feelings about / experience with the law of attraction/manifesting?* This field is required.Pick the answer that most closely matches.
I don't know much about it, but am interested in learning more.
I am a big believer and want to get better at manifesting.
I don't believe in any of that new age woo-woo stuff.
I have no idea what you're talking about.
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Why do you think it is that you haven't yet manifested the relationship you want?* This field is required.
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Are you open to the use of energy work, meditation, hypnosis, and law of attraction (manifesting) to achieve your goals in your love life?* This field is required.
Yes
No
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What are your feelings about online dating?
I think it's great!
I don't know, I haven't tried it.
I'm not a fan, but maybe I'm just not doing it right. Open to learning how.
It's frustrating, but I feel like I don't have any other options.
No way, no how, never going to do it, no matter what.
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After the free call, if you love what you hear, would you be able and willing to invest financially in a program that can get you the result you are seeking -- namely, the love of your life?* This field is required.
Yes, if I really believe in the program and the coach.
No. Even if I believe I can get the results I want, I'm not financially able (or willing) to invest.
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What is your current professional/employment status?* This field is required.
Full time employed ( professional / managerial )
Full time employed ( sales / corporate )
Full time employed ( skilled trades )
Full time employed ( laborer / retail )
Full time employed ( other )
Part time employed
Unemployed / Disability
Self-employed
Financially Independent
Retired
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At this point in your life, how important is it to you to find love?* This field is required.
There is nothing more important to me. I am happy and satisfied in other areas of my life. This is the one thing that's missing, and I want someone to share it all with.
It's important, but I'm not sure if it's important enough to risk getting hurt.
If it happens, great. If not, that's fine too.
I have more important things to worry about. It's not that important.
I want it very much. I'd say it's at the top of my priority list right now.
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Do you consider yourself open-minded, coachable, and willing to learn and grow? (i.e., are you ready to make changes in your beliefs and behaviors in order to get different results in your love life?)* This field is required.
Yes
No
Not Sure
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Do you have time (or can you make time) in your life to put in the effort to get what you really want in terms of love?* This field is required.
Yes
No
Not Sure
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Other than love, in what areas of your life are you currently struggling?* This field is required.Please select one or more.
health
finances
family issues
other
nothing else but love
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We get over 300 applications each month for free calls and cannot accept them all. In addition, we only give ONE free call opportunity to those who qualify based on this application... so please think about this question and answer honestly: Which one of these statements below, best applies to you, right now?* This field is required.
This is my time! I am ready to take action to change my love life, right now!
I do want love, but I'm not sure if I'm ready to take action or make any changes right now.
I'm not even sure if I want love, or if I'm ready take action or make any big life changes right now.
I'm definitely not ready to take action or make any big life changes right now.
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Is there anything else you would like to add to your application to further explain why you want to book this call?* This field is required.
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Tags
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