Kaleidoscope Application Form

WELCOME!

Kaleidoscope is Life on Purpose's group coaching experience (includes six 75-minute group sessions and up to two hours of private coaching sessions) designed to help you reclaim your authentic self, reconnect with possibility, and create an action plan for a life that sparks joy and purpose!

Group session schedule:
September 11, 18
October 2, 9, 16, 30

Group sessions will be held Wednesdays from 6-7:15 p.m. PT.

Private sessions will be scheduled individually to best fit your schedule.

Program cost: $1100
or 2 payments of $575

(If you know that you want to join the group at this time but feel extremely hindered due to financial circumstances, please book a call with me to discuss alternative arrangements.)

If you have any questions, or there's anything on the application you'd prefer to talk about first, please don’t hesitate to reach out: jenwestracoaching@gmail.com.

I'm so excited to welcome you to Kaleidoscope and look forward to talking to you soon!

Jen Westra

Your Name*

First NameLast Name

E-mail*

Preferred Phone Number*

Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

What sparked your interest in Kaleidoscope?*

What would you love to be different at the end of the program?*

What is (are) your biggest current challenge(s)?*

YesNo

How did you hear about Kaleidoscope?

Any other comments or questions?

Program Application