Apply to Work with Me
I’m ready and open to working with those who are truly interested in doing the work it takes to step into their confidence and power.
Please fill out this application with honesty and vulnerability so that we don’t waste each other's time, energy, or money. This offering incudes 12 consecutive weekly sessions, including a 1.5 hour introductory session, followed by 11 separate sessions, each 1 hour long. The total cost of this program is $3,333. A $100 deposit will be required at the end of this application.
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Name
*
First Name
Last Name
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Email
*
example@example.com
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Phone Number
*
Please enter a valid phone number.
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In a sentence, what has you interested in working with me?
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What do you see as your 3 greatest gifts?
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What 3 parts of your personal character do you struggle with most?
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How prepared are you to commit $3,333 and dedicated time to this one on one coaching program if it turned out to be the perfect fit for you?
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Totally prepared
Somewhat prepared, I’d need to think about it and gather some resources
Not prepared at all, but I’d figure it out
Not prepared to and wouldn’t want to
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Describe the type of life you hope to create as a result of working on yourself through this program?
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What do you NOT want me to know about you during this application process?
*
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In *a single word* how would you describe the new chapter of your life you're ready to step fully into?
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Where did you discover this program? (I’d like to reach men where they’re at, so your honesty is appreciated, always.)
Instagram
YouTube
Twitter
TikTok
OnlyFans
Facebook
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Is there anything else you’d like me to know about you?
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Once your application is submitted I will contact you via email within 7 days.
Please be sure to click the green “Submit” button below, once you’ve completed your application and made your $100 deposit. IF YOU’D LIKE TO USE A CREDIT CARD, you’ll be offered that option after clicking the “PayPal Checkout” button.
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$100 Application Deposit
If you’re accepted into the 12 week program this deposit will go toward the total cost of the program ($3,333). If you aren’t a fit for the program your deposit will not be refunded, so please make sure you’ve filled out this questionnaire with sincerity and effort.
$
100.00
Payment Methods
Please click one of the PayPal options to complete payment and
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the form.
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