🚀 Introducing the "Elevate Your Mindset 7-Day Empowerment Boot Camp"! 🚀

Full Name*

First NameLast Name

What's your e-mail address?*

example@example.com

Mobile Number*

Gender

FemaleMaleOthers

What is your Biggest Strength?

What is your Biggest Weakness?

What brought you to Elevate Your Mindset 7-Daytime Empowerment Boot Camp?*

What are outcomes you are looking for as a result of you joining the Boot Camp?

State your expectations from me "Your Coach"

How did you learn about the program? Which agency referred you?

Are you formerly incarcerated?*

YesNo

What led to your incarcaration?

Can you start this program January 8, 2024?*

YesNo

What are your preferred meeting days in a week?*

What are your preferred time slots?*

9:00 - 10:00 am10:00 - 11:00 am1:00 - 2:00 pm3:00- 4:00 pm

State Your Limitations?

EXPECTATIONS OF YOUR COACH

1. Full Commitment: Attend all sessions and actively participate.

2. Openness to Change: Be willing to challenge and change existing beliefs and behaviors.

3. Honest Self-Reflection: Engage in sincere introspection about personal experiences and goals.

4. Mutual Respect: Show respect for the diverse experiences and backgrounds of others in the group.

5. Confidentiality: Maintain the privacy of shared experiences within the group.

6. Personal Responsibility: Take charge of your own growth, applying what you have learned in daily life.

7. Adherence to Rules: Follow the program's guidelines and complete assigned tasks.

8. Effective Communication: Be open and honest in providing feedback and expressing needs.

9. Resilience: Stay persistent and resilient in the face of challenges.

10. Seek and Accept Support: Be open to receiving and asking for help when needed.

IMPORTANT NOTE

All the necessary information shared by you during the entire process will be treated as confidential and will not be share your coach with anyone.
Your consent will definitely be taken under circumstances where sharing of information with a third party is necessary.

Are you in ?*

YESNO