Application to Join our Practitioner Consultation Group!
Please take a few minutes to complete this application. We want to know this will be a good fit for you and that the composition of the group is good for all involved. We are limiting the size of our group so if you are interested we encourage you to submit your application right away!
Name
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First Name
Last Name
Email (please enter the best email for us to let you know about your application.)
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example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
If we cannot reach you above, may we leave a message? (We want to respect your privacy)
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yes
no
Where do you reside? (Location)
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What Group are you Applying for?
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Please Select
Spark Group- Beginners
Ignite Group- Intermediate/Advanced
What is your Current Profession/Career?
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Mental Health Practitioner
Holistic/Alternative Professional
Medical Professional
Massage Therapist
Wellness Coach
Nutrition Professional
Havening Practitioner
Somatic/ Trauma Practitioner
NLP/ Energy/ Reiki Practitioner
Yoga/ Movement Based Instructor
Teacher/ Professor
Other
How did you find out about us?
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Back
Next
Who are you? We want to get a sense of you...
Please take a moment to answer the following questions. We want to make sure that everyone that is accepted into the group is able to get immense value personally and professionally, and that the overall composition has a degree of synergy for maximum support and growth.
Name
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First Name
Last Name
What motivated you to apply to this group/training?
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What is your professional website? (or social media) If you don't have one, you can indicate that.
What are your goals? What do you want to accomplish and how do you think this group will help you?
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What do you hope to get out of this group?
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What is your professional experience with mental/emotional health and wellness?
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What is your experience with business building, marketing and sales?
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What are unique skills and gifts you believe you can contribute to the group?
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What questions or concerns you have about joining our group?
The group is meant to provide you with support, mentoring, accountability and training for 12 months. The investment is $498 a month for 12 months. If you are accepted into the group are you willing and able to
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Yes I understand that I will invest only $498 monthly for personal and business growth!
I am not ready to make that kind of investment on myself and my business
Yes I am! And I have some questions I'd like answered (feel free to add these in the last block.)
If your application is accepted, are you ready to join the group?
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Yes! Absolutely
I have some questions and would like to speak with someone
I am just browsing
Other- fill below
Anything else you'd like to share about you, your goals or your commitment level?
Signature
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Finish
Finish
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