BREAKTHROUGH APPLICATION
Breakthrough is a transformational 12-week coaching journey designed for women who feel like they are meant for more but battle feeling stuck, overwhelmed, or limited. It blends faith, mindset work, emotional healing, and spiritual development to help women overcome imposter syndrome, low self-worth, fear, and unresolved pain. Through weekly holistic themes such as identity, purpose, wellness, inner healing, mindset, relationships, and vision, the program includes live coaching sessions, group discussions, journaling, scripture, and mindset tools. It supports women in building confidence, strengthening faith, healing emotionally, gaining clarity, and taking bold action toward their purpose. This program attracts women who are ready to do the inner work, grow spiritually and emotionally, and align their lives with purpose.
Name:
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Email:
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Phone Contact
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Age:
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Occupation:
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Country:
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What day and time is best to contact you?
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Why did you sign up for Breakthrough?
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What specific challenges or areas of your life do you want to work on during this program?
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What are your main goals or outcomes you hope to achieve by the end of the program?
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Self Esteem & Self Worth
My Faith & Relationship with God
Relational Intelligence
Emotional Intelligence
Healing from Trauma
Rejection & Abandonment Challenges
Feeling stuck or stagnated
I need accountability
Health & Wellness
Financial Literacy
I don’t know, I just need a change
Other
How committed are you to making changes in your life (on a scale of 1–10)?
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How open are you to correction or other perspectives (on a scale of 1-10)?
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Are you open to receiving feedback and challenging your beliefs to grow?
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Yes
No
Are you open to group coaching?
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Yes
No
What is your personality type?
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Introvert
Extrovert
Ambivert
Do you have any financial considerations or constraints when it comes to joining this program?
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Yes
No
Is there anything that would prevent you from fully committing to this program?
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NO
Financial Challenge
Time Commitment
Fear
Uncertainty about Coaching
Other
If you selected 'Other', add reason below:
Have you ever worked with a coach? If not, please state No, but if you have, what did you like or dislike about that experience?
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What is your budget?
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$500
$1000
$2000
$3500
Do you have a support system?
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Yes
No
What values or principles are most important to you when working with a coach?
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Are you open to working with a faith-based approach in coaching?
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Yes
No
Do you have anything you would like to share?
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Submit
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