ElevateHER Application Form
Thank you for your interest in ElevateHER, a transformational group experience for women ready to reconnect with their bodies, release emotional blocks, and rise into their most aligned, powerful selves. Please take your time filling out this application so we can ensure this is the best fit for you.
Name
First Name
Last Name
Email
example@example.com
Why are you interested in the ElevateHER program? What drew you to it?
What are you currently struggling with (physically, emotionally, or energetically) that you hope to shift?
In what areas of your life do you feel most out of alignment or stuck right now?(Business, health, mindset, self-worth, relationships, etc.)
Have you done any personal development, therapy, or healing work before? If so, what has helped you most so far?
What does your ideal, aligned life feel like in your body?Examples might include: peaceful, light, energized, grounded, open-hearted, free, confident, nourished, safe, playful, connected, etc.
Do you currently run a business or have a career you're building? If yes, tell me about it.
How would you describe your current physical health and energy levels?
What are your current non-negotiables in life (if any)?Examples: movement, boundaries, screen-free time, spiritual practice, self-care, no work weekends, therapy, etc.
How do stress, burnout, or emotional overwhelm typically show up in your business, body or life?
Are you currently receiving support (coaching, therapy, mentorship, etc.)? If yes, what kind?
This program includes group coaching calls, embodiment practices, journaling, and somatic healing work. Are you open and willing to go deep, reflect honestly, and try new things outside your comfort zone?
Yes
No
Maybe - I'm open but a bit nervous
The investment for this program is $1500 USD. Are you in a place to make this investment in yourself if it feels aligned?
Yes
I'll make it work
Not at this time
Is there anything else you'd like to share or ask to help me get to know you better?
Submit
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