Challaine's Phoenix Rising Scholarship
Appplication
Name
*
First Name
Last Name
Email
*
example@example.com
Birthday
-
Month
-
Day
Year
Date
Phone Number
*
Please enter a valid phone number.
Please provide a high-resolution headshot to utilize for promotional purposes should you be the winner!
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Your Story- Tell me about your journey. What challenges, traumas, limiting beliefs have you faced that you’re ready to overcome?
*
Your Goals- What do you hope to achieve through this year of coaching with me? (e.g., healing, confidence, a specific dream)
*
What’s the hardest moment you’ve endured, and how has it shaped who you are today?
*
Why is now the right time for you to start this transformation?
*
What do you hope to achieve through this year of coaching with me?
*
What’s one belief about yourself you’re afraid to let go of, and why do you think it’s holding you back?
*
What’s the biggest sacrifice you’re willing to make to fully commit to this year of coaching, and why?
*
Imagine you’ve completed this year with me and risen like a phoenix. Describe who you are and what your life looks like in vivid detail.
*
What scares you most about this process, & how will you push through that fear?
*
Commitment- On a scale of 1-10 (1 being I just like free stuff, 10 being I'm ready to learn, grow and be my best self EVER), how committed are you to doing the work required to rise and thrive?
*
Connection to the Scholarship- Why do you need this scholarship? (e.g., financial barriers, lack of support, etc.)
*
How did you hear about Challaine’s Phoenix Rising Scholarship?
*
Consent & Confirmation- I understand that my likeness will remain confidential within Challaine Professional Services & it's staff and that submitting this application doesn’t guarantee selection.
*
Yes
No
I understand that if I am not selected that I will receive a complimentary coaching call where we will discuss how we can work together at a discounted rate and I will will take advantage of more freebies like the 21 Day Ultimate Self Care Revolution Guide
*
Yes
No
I understand that if I am selected for the FREE year of coaching with Challaine, my personal/confidential information (ex. phone/email/address) will remain confidential within the agency and staff who are held to the same confidentiality standards as Challaine. Results Name/Image may be shared for advertising purposes. Name/Image may be shared to publicly congratulate the winner.
*
Yes
No
I understand that this application does not outline the terms and conditions of the client/coaching program. Should I be chosen this will be disclosed. I will read them at www.challaine.com
*
Yes
No
I understand that I will be contacted via email & text message. I have triple checked that my contact information is accurate. If I don't respond within 48 hours of initial contact from connect@challaine.com or admin@challaine then my spot will be forfeited and will go to someone else. I will ensure that I have safe listed this email so I don't miss this opportunity of a lifetime!
*
Of course
No way
I confirm that I am 18 years of age or older- MUST be 18 to apply and receive coaching
*
Yes
No (If you select this option unfortunately we won't be a good fit at this time)
Signature
Apply
Apply
Should be Empty: