ASCEND Application

1

Name

First Name

Last Name

2

Email

example@example.com

3

Phone NumberOption - but answer for texting updates

Please enter a valid phone number.

4

Give us the URL to your favorite online social media channelWhere do you hang out the most? Insta? TikTok? LinkedIn? Facebook? Cool! Send us your URL

5

Tell us about YOU!Who are you? What's your story in a few sentences?

6

What inspired you to apply for ASCEND right now?Why this program? Why now?

7

Which of the following areas are you most committed to improving during this 6-month mastermind?Select all that apply

Business or Career Growth

Financial Clarity & Abundant Mindset

Mindset & Confidence

Health, Energy & Self-Care

Supportive Community / Accountability

All of the Above

8

What is ONE bold goal you want to accomplish by December 2025?

9

What has held you back from hitting that goal so far?

10

On a scale of 1–10, how ready are you to take bold, consistent action toward your goals?

11

This is a paid coaching program - because we believe that when you pay, you pay attention and show up more fully!The investment is $497/month for 6 months or $2,982 pay in full. Are you ready and willing to invest in yourself to be part of ASCEND?

Yes, I'm ready to pay in full

Yes, I'll use the easy payment plan

I'm not sure yet - I have a few questions

No - I'm not ready to invest in myself yet

12

If you have questions, fears or reservations, what are those?Please speak freely so that we can be sure to answer your biggest questions!

13

If accepted, are you available to join our kickoff call the week of July 1st?

YESNO

14

Anything else you'd like us to know?

15

How did you hear about ASCEND?

Ladies Kickin Ass Podcast

NicoleMBurbank.com/YHHJ

Instagram/Social Media

Friend/Referral