Visionary Leader VIP Retreat Application

1

Please Tell Us Your Full Name* This field is required.

First Name

Last Name

2

From what part of the world will you be joining us?* This field is required.

City

State / Province

Country

3

Where should we email your confirmation?* This field is required.

example@example.com

4

Please tell us your phone number.* This field is required.

5

Your Leadership Space: Which best describes your current leadership role?* This field is required.

Executive or founder in reinvention

Coach/consultant scaling with soul

Emerging thought leader seeking clarity

Heart-centered entrepreneur aiming for legacy

Professional considering entrepreneurship

Other (please specify)

6

Your Current Season* This field is required.What season of life are you in right now?

7

What life transition or inner calling brought you here?* This field is required.Example: Divorce, loss of job, close of business, loss of loved one, empty nest, approaching retirement, etc.

8

Your Vision & Purpose: What does your soul crave next?* This field is required.

9

Why is now the right time for you? What do you hope to receive in this container for visionary leaders?* This field is required.

10

Where do you feel most stuck or uncertain right now?* This field is required.

11

In what areas or ways would you like support?* This field is required.Let us know how you think we can assist you.

12

Defining Success & Commitment: How do you define success at this stage of your life?* This field is required.

13

This gathering has the potential to completely change the trajectory of your life in ways you choose. Are you prepared to fully invest in this experience (time, focus, heart, and finances)?* This field is required.

Yes, I'm all in

I'm ready, but I'm nervous

I want to be, but I need support or clarity

14

Are you able to travel if necessary, and attend the gathering(s) in person?* This field is required.

Yes

Not sure - I'd like more information

No, I'm interested in a virtual option

15

Is there anything else you'd like Baylan and her team to know?* This field is required.

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