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Name
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First Name
Last Name
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Please share your preferred first name, or nickname, and your preferred pronouns
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For those who haven’t done this before, this is a way that we can avoid assumptions, particularly about gender. For example, your guide on this journey prefers to be called Andrea and uses the pronouns she/her/hers. Options are typically: *she/her/hers *he/him/his *they/them/theirs(singular) *ze/hir/hirs
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E-mail
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Phone Number
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Country Code
Area Code
Phone Number
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Your handle for Whatsapp/GoogleVoice/IG/FB if you prefer an app-to-app call:
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Mailing Address... a box of our favorite things is going out to only our first 2022 members
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Street Address
Street Address Line 2
City
State
Zip Code
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Age (must be over 18 to participate)
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8
How did you find about Andrea Luzon and Connected Parents Program?
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9
What do you really want to experience or heal in your life that you're not currently experiencing? Please be as descriptive as possible here
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Why do you think you don't have what you want yet?
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11
By bringing this area of your life into deeper alignment, what do you imagine the impact to be on your personal or professional life and financial abundance?
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Have you ever worked with a coach, healer, or therapist on similar issues? If so, what was the outcome?
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13
Please select which best describes you right now..
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I have the financial resources to invest in improving my life
I have access to the financial resources to invest in improving my life
I have minimal financial resources to spend on this area of my life and prefer to do things as cheaply as possible
I don't have any financial resources at the moment to invest in this part of my life
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14
If you could wave a magic wand and change anything about yourself or your life, what would you change? How would you be different?
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What is your current profession or line of work? What would you be doing if you could do or create anything you wanted to? Reach for the stars!
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What makes you extraordinary? (This is the place to brag)
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17
What things are you most proud of accomplishing up to this point in your life?
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18
Are you ready to release what you've declared to release and create your best life?
Yes
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