MHS Membership Application
To apply for membership please complete all questions.
Name
First Name
Last Name
E-mail
example@example.com
Home Number
Cellular Number
Are you applying to become a Member?
Yes
No
Other
Are you applying to become a Team Leader?
Yes
No
Other
Did you sign the confidentiality agreement and agree to the terms?
Yes
No
Other
What term are you applying?
Year 2025
Year 2026
Year 2027
Other
Memberships
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( X )
Gold Membership
Foundational support, coaching check-ins, and access to our core workshops and wellness tools
$
299.00
Quantity
1
2
3
4
5
6
7
8
9
10
Platinum Membership
Deeper access with personalized coaching, private strategy sessions, and early access to new resources
$
499.00
Quantity
1
2
3
4
5
6
7
8
9
10
Diamond VIP Membership
Exclusive VIP Diamond Membership The most immersive experience with VIP coaching, executive retreats, mental wellness intensives, and curated peer connections
$
1,299.00
Quantity
1
2
3
4
5
6
7
8
9
10
First Meetings (Free)
First Time Group Meeting
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Signature
Signing Date
-
Month
-
Day
Year
Date
SUBMIT
SUBMIT
Should be Empty: