Application For The Anti-Burnout Course 2024
Embark on a journey to rediscover joy, balance, and resilience in every aspect of your life!
Customer Details:
Full Name
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First Name
Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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E-mail
example@example.com
How Did You Hear About Us?
Which Group Are You Applying For?
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Group 1 (Mondays @ 10:00am MST, January 22, 2024 to March 18, 2024)
Group 2 (Wednesdays @ 12:00pm MST, January 24, 2024 to March 20, 2024)
Why are you applying for the Anti-Burnout Course?
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On a scale from 1-10, how motivated are you to make changes to your life to reduce burnout?
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Not at all motivated
1
2
3
4
5
6
7
8
9
Very motivated!
10
1 is Not at all motivated, 10 is Very motivated!
If accepted to the program, can you pay the $1592+GST lump sum payment before February 22nd 2024, or would you like to apply for one of the four Pay What You Can spots?
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I would not like to apply for Pay What You Can
I would like to apply for Pay What You Can
Is there anything else you'd like to share with us?
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Submit
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