The Becoming Form

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Phone Number* This field is required.

Please enter a valid phone number.

4

Which statement feels most true right now?* This field is required.

I want more, but I’m scared of what it might cost

I know I’m meant for more—I just need support

I don’t believe more is possible for me

I’m already becoming who I’m meant to be

I’m still figuring out what I even want

5

How often do you feel like the best version of yourself?* This field is required.

Rarely—I don’t recognize that version of me yet

Occasionally—I catch glimpses but it doesn’t last

Sometimes—I tap into her/him/them in certain spaces

Often—I know how to embody that version now

Daily—I live as my highest self with intention

6

What do you believe about your value right now?* This field is required.

I feel like I still have to earn it

I know I have value, but I hide it

I’m learning to trust that I’m enough

My worth is undeniable and non-negotiable

7

If you were to die today, would you be happy with yourself?* This field is required.

YESNO

8

What version of you are you ready to release?* This field is required.

The one who plays small

The one who pleases everyone

The one who overworks to feel worthy

The one who stays silent

The one who doubts their light

9

What do your actions say about you?* This field is required.

10

What have you been tolerating that you know you’ve outgrown?* This field is required.

Relationships that drain me.

A version of myself that’s based on survival.

A routine that keeps me small.

Nothing—I’ve cleared what doesn’t belong.

11

Please verify that you are human* This field is required.