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Personal Growth & Self-Empowerment Course
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Name
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First Name
Last Name
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Email
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example@example.com
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Phone Number
Area Code
Phone Number
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4
What describes you best
I thought of these options, you can choose the ones you think would grab the most attention
I feel lost, and I don’t know where to start, I just know something needs to change.
I struggle to communicate my boundaries without guilt or over-explaining.
I want simple, gentle steps to build emotional resilience without overwhelming myself.
I feel a lot inside, but I don’t know how to express it in words.
I take care of everyone else, but I’m not sure how to take care of myself anymore.
I feel disconnected from myself and want to feel grounded and present again.
I want to understand my emotions instead of suppressing or avoiding them.
I’m tired of “coping”, I want to feel more stable and self-led.
I want to reconnect with my inner voice and trust myself again.
I’m curious about personal growth, but I need a safe, non-overwhelming way to begin.
I want to express myself freely without needing to be good at art or explaining myself.
I’m in a transition and need clarity, grounding, and inner support.
I thought of these options, you can choose the ones you think would grab the most attention
I feel lost, and I don’t know where to start, I just know something needs to change.
I struggle to communicate my boundaries without guilt or over-explaining.
I want simple, gentle steps to build emotional resilience without overwhelming myself.
I feel a lot inside, but I don’t know how to express it in words.
I take care of everyone else, but I’m not sure how to take care of myself anymore.
I feel disconnected from myself and want to feel grounded and present again.
I want to understand my emotions instead of suppressing or avoiding them.
I’m tired of “coping”, I want to feel more stable and self-led.
I want to reconnect with my inner voice and trust myself again.
I’m curious about personal growth, but I need a safe, non-overwhelming way to begin.
I want to express myself freely without needing to be good at art or explaining myself.
I’m in a transition and need clarity, grounding, and inner support.
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5
What is your goal?
I want clarity and direction in my life.
I want to set boundaries with confidence and ease.
I want to build emotional resilience without overwhelm.
I want to express myself freely and authentically.
I want to take better care of myself.
I want to feel grounded and present in my daily life.
I want to understand and work with my emotions.
I want to feel emotionally strong and self-led.
I want to trust myself and my decisions.
I want a gentle place to begin my personal growth journey.
I want to express myself without needing artistic skills.
I want support and clarity during times of change.
I want clarity and direction in my life.
I want to set boundaries with confidence and ease.
I want to build emotional resilience without overwhelm.
I want to express myself freely and authentically.
I want to take better care of myself.
I want to feel grounded and present in my daily life.
I want to understand and work with my emotions.
I want to feel emotionally strong and self-led.
I want to trust myself and my decisions.
I want a gentle place to begin my personal growth journey.
I want to express myself without needing artistic skills.
I want support and clarity during times of change.
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6
Were are you located?
Dubai
Abu-Dhabi
Sharjah
Ajman
Umm Al-Quwain
Fujarah
Other
Dubai
Abu-Dhabi
Sharjah
Ajman
Umm Al-Quwain
Fujarah
Other
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7
How do you prefer to study?
Online at my own pace
Online classes with a group
Group face to face classes
Online and On Campus
Online at my own pace
Online classes with a group
Group face to face classes
Online and On Campus
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Have you got any question?
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