Your VIP Day Application

Are we a good fit?

Thank you for your interest in reserving a VIP Day with Coach Cayme Andrea. The below questions are very personal. Don't be alarmed. Your answers will not be shared with anyone outside of our team. We provide transformative alignment inside a safe, inclusive community, therefore we must vet each participant and make sure we're a good fit. If the questions seem too personal, that may be a good indication that our program is not the right match for you.
Participation Is By Application & Deposit Only.

To protect the integrity of this experience, participation is by application and deposit only. As part of the application process, you are making a non-refundable $500 deposit to denote your intention to join us for this one-of-a-kind experience. You will also complete the below detailed application so we can make sure this is the right place for you. Once your application is approved, you will be given the opportunity to make your investment in full or enter our payment plan. Your deposit will be added to your final payment if approved. This deposit is non-refundable and will only be returned if you are not approved for a VIP Day.

Part 1: Logistics
Your First Name:*
Your Last Name:*
Pronouns*
Your email address *
example@example.com
Your phone number*
Please enter a valid phone number.

Part 2: Your Heart Story (long form questions)
Tell us about your family (married? single?) and any significant relationships:*
We want to get the most accurate picture of you possible.
What are the three biggest changes you want to make in the next month? Three months?*
All coaching looks inward first. What in you (in your core beliefs, thoughts, behaviors, etc,) may require adjustment to help you to live your best life? Be honest, otherwise coaching will not work.*
What are your top five accomplishments thus far in your life?*
Share five facts about your background – anything that will help us understand you and allow us to better support you.*
What are the three biggest changes you want to make in the next month? Three months?*
What would you be missing out on if you did *not* work towards those changes?*
What habits, activities, or thought processes do you believe need to be dropped, simplified or let go of in order to truly, quickly move forward?*
The one thing I would like most to accomplish (but haven’t yet) is:*
The one thing I wish I could change in the short-term is:*
On a scale from 1-10 (10 being exactly what you want), finish this sentence: My life fulfillment quotient is _________.*

1

2

3

4

5

6

7

8

9

10

1 is There's a lot of room for improvement, 10 is It's exactly where I want it.
Is there anything you can think of that could potentially hold you back from fully participating? List it below:*
Knowing that the previous response could hold you back, what is one thing you will do to create success for yourself?*
Is there anything that you would like Coach Cayme to know about you?*

VIP Day Application Deposit*

VIP Day Application DepositTo protect the integrity of this experience, participation is by application and deposit only. As part of the application process, you are making a non-refundable $500 deposit to denote your intention to participate in this one-of-a-kind transformative VIP experience. NOTE: The deposit is non-refundable and only returned if you are not approved to participate.

$500.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

Are we a good fit?

Participation Is By Application & Deposit Only.