Application for 'The Life Consulting MasterClass'
These questions help us understand you and your journey better. There are no right or wrong answers. Honesty and authenticity are our highest value. When a question is not applicable please type in the answer box (N/A) and move forward. Thank you for taking time to apply to LCMC 2024 and allowing us to be a part of your journey.
Personal Information
Tell us all about you!
Name
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First Name
Last Name
E-mail
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We will use this email to communicate with you for all LCMC related items moving forward
Referred by:
Phone Number
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Full Address
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We need this for shipping purposes and time zones if you are accepted.
Age
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Gender
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Male
Female
Date of Birth
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Occupation
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What global time zone do you live in?
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List two to four - 2 hour time slots that you have available each week:
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If accepted we will use these time slots to add in school scheduled elements
Headshot
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Browse Files
Please upload a headshot or recent picture of yourself here
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Please provide us a reference that we can talk with regarding your application.
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First Name
Last Name
How do you know this reference?
Reference Phone Number
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Reference Email
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example@example.com
Emergency Contact
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First Name
Last Name
Emergency Contact Email
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example@example.com
Phone Number of Emergency Contact
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-
Area Code
Phone Number
How did you hear about us?
What is your Meyers-Briggs
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What Enneagram # are you?
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Which Stumvoll Consulting programs have you participated in:
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Living Fully Alive
Living Fully Alive: The Immersion Program
Living Fully Alive: The Mentorship Program
Living Fully Alive: The Four Week Extension Program
The Pathway to Freedom
The Pathway to Freedom: The Immersion Program
The Compassion Project
The Father Series
1:1 Sessions with a Life Consultant that was trained with Abi and Justin
I've never taken a Stumvoll Consulting Course
What is your reason for applying to this MasterClass?
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Please check which emotions you are currently on the journey of facing and processing.
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Fear
Anxiety
Anger
Rage
Hatred
Self-hatred
Loneliness
Depression
Sadness
Hopelessness
Rejection
Unforgiveness
Doubt
Abandonment
Shame
Guilt
Condemnation
Emotional Pain
Not listed
Anything we missed that you would like to share?
Now let's go deep...
Please share in as much detail as you are able about your personal experience.
Do you currently work, have worked, or have training in the emotional health field? If so, which area? (Life Coach, Life Consultant, Therapist, Counselor, MFT, etc…)
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If yes, are you currently meeting with clients? If so, how many?
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If yes to the previous question, how long have you been working in this field and what training have you previously had?
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How did you first get started working with people (professionally or not)?
Do you have an area of expertise? (This may simply be an area of personal growth and development that you have a strong understanding of.) For example, eating disorders, relationships, marriage, trauma, etc.
What have you personally overcome in your life that has helped you with helping others overcome?
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Please list any healing modalities that you’ve attended for personal growth. (Life Coaching, Counseling, Therapy, Psychiatry, Inner Healing, Sozo etc.)
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To the best of your memory, please elaborate on the regularity of your sessions within these modalities. (How many sessions, how many weeks, months, years, etc.)
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Please tell us about your experience. What were you meeting for? Was it helpful? If so, what breakthrough did you receive? Was it a positive or negative experience and why?
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Please briefly elaborate on the above process. If you checked "Not Listed" please list it below.
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What are five things you are proud of yourself for?
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What’s one area of shame in your life that has a tendency to flare up? How do you navigate it?
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What’s one thing/situation/person in your life that you’re scared to confront and why?
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Describe a difficult relational conflict, how you went about confronting it, or being confronted, and how you reconciled it.
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What’s one area in your life that you feel very powerful and capable in?
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What are three things that you consider accomplishments in your life?
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Describe a time that you failed and had to be confronted and corrected. Include how you felt and how you processed through it.
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What are four of your biggest triggers?
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What are five strengths that you perceive that you have in working with people?
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What are five weaknesses that you perceive that you have in working with people?
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When was the last time you cried and what was it about?
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Have you gone through trauma(s)? If so, give a brief summary.
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Have you received healing for areas of trauma(s)? If so, give a brief summary of your process.
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Have you ever been hospitalized for a mental illness or substance abuse? If so, please explain.
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Have you ever been diagnosed with a mental illness? If so, please list below.
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Please list below any/all present or past medications pertaining to mental health:
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Do you have a support system/community? If so, what does that look like in your life?
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Do you feel like it’s easier to have vulnerable conversations with men in authority or women in authority?
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What is something you want us to know about you?
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What do you hope to get out of this MasterClass if you’re accepted?
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LCMC is not designed to be a form of treatment for mental health difficulties that significantly impact your ability to live life in a way that you or others find acceptable. Gathering this information about your mental health history helps us know how to best support you if you are accepted into LCMC.
Have you ever experienced a mental health difficulty that affects your ability to live life in a way that you or others find acceptable (i.e. bipolar, schizophrenia, PTSD, BPD, anxiety disorder or depression)?
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Yes
No
Please describe how this affects your ability to live your life in a way that you or others find acceptable.
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If yes, have you ever been under the care of a mental health professional for the difficulty you experienced (i.e. psychiatric inpatient, outpatient team, psychologist, psychiatrist). Please describe the treatment you received.
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Are you currently on any medication to help with a mental health difficulty? How long have you been taking this medication?
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Yes
No
Please describe how you feel this medication affects you. If you are currently taking medication, please let us know if you plan to stop taking it during the course of study with LCMC.
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Have you ever engaged in any self harm behaviors (i.e. cutting, burning, biting, hitting, starvation, binging and purging)?
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Yes
No
If yes, how long did you engage in these behaviors and how frequent were they?
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Have you ever experienced thoughts of wanting to end your life?
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Yes
No
If so, how long ago was this? How frequently would you experience these thoughts?
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Have you ever attempted to take your own life?
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Yes
No
How long ago was this? Was this an impulsive decision or something that was thought out?
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Are you currently experiencing thoughts of wanting to end your life?
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Yes
No
Please check this box to indicate that you understand the following: I understand that the price of this course is $13,500 under the payment plan or $12,500 paid in full. I’m aware of this information as I am submitting my application to be reviewed.
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I've read and understand the above statement.
Please check this box to indicate that you understand the following: I understand that if I have questions prior to submitting this application, I can email support@stumvollconsutling.com to get any information that I need.
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I've read and understand the above statement.
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