Xpansion Protocol Application
Fill out the questions below to qualify for a seat to our 4-day Xpansion Protocol experience in Destin, FL.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Shirt size
*
Please Select
Small
Medium
Large
XL
2XL
3XL
4XL
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Next
Which is most important to you?
*
Please Select
People (Relationships)
Power (Physicality)
Production (Career)
Peace (Spirituality)
Are you in shape physically?
*
Yes
No
How often do you exercise?
*
1-2 times per week
3-4 times per week
4-5 times per week
6-7 times per week
Not regularly
Never
What is your relationship status?
*
Please Select
Married/In a relationship
Single
Divorced
Widowed
How would you rate your marriage?
Weak
1
2
3
4
5
6
7
8
9
Strong
10
1 is Weak, 10 is Strong
Do you have any children?
*
Yes
No
How would you rate the relationship with your children?
Weak
1
2
3
4
5
6
7
8
9
Strong
10
1 is Weak, 10 is Strong
Are you spiritual or religious?
*
Spiritual
Religious
Both
Neither
How do you feel about your spirituality/religion?
*
How often do you meditate, journal, and/or pray?
*
Daily
Weekly
Monthly
Not regularly
Never
Are you self-employed?
*
Yes
No
What industry are you in?
*
Are you happy with your current job/business?
*
Yes
No
Are you hitting your financial goals?
*
Yes
No
To the above question: Why or Why not?
*
What is/are the biggest obstacles preventing you from achieving your financial goals?
*
How much money did you take home last year?
*
Is changing your life crucial for you right now?
*
Yes
No
To the above question: Why or why not?
*
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Next
Do you want to be interviewed for one of the spots at Xpansion Protocol?
*
Yes
No
I understand that my tuition for a seat at Xpansion Protocol is $5,000. If selected to take one of the seats, I am ready to invest time, energy and money to begin creating results that matter.
*
Yes
No
I understand that I will cover all travel expenses (plane, hotel, etc)
*
Yes
No
I understand that I must arrive on November 18th and depart on November 23rd (the event dates are November 19th-22nd).
*
Yes
No
How did you hear about Xpansion?
*
Please list any food allergies:
Please list any injuries that may prevent you from certain activities:
Upload one image of your family (i.e. a family photo)
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