The Authors of Impact Mentorship Program
Application Form
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please summarize what you would like to write your book about and why.
*
Please submit a writing sample of no less than 300 words (blog post, article, etc)
*
If invited into this mentorship program will you commit (to the best of your ability) to submit your chapters on or before the due date each week?
*
Yes
No
If invited into this mentorship program will you choose to allow me to be your writing coach and receive constructive feedback as a positive thing - understanding that I am cheering you on with all that I am and just want your best story to come through?
*
I'll do my best
I don't actually want to grow :/
If invited into this mentorship program do you agree to pay the monthly fee of $997 USD (for 6 months)?
*
Yes
No
Thank you for your submission! I will get back to you shortly to let you know if you have been chosen for this mentorship program.
Submit
Should be Empty: