yOU Are Worthy Challenge Application
Hosted by: Healing yOUR Life
Why do you need to apply?
Your answers help us make sure this community is the right fit - where moms show up for themselves, stay open to growth, and uplift each other. Supportive and non - judgemental.
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Pronouns
He/him
She/Her
They/Them
Other
Age
<18
18-20
21-25
26-35
36-45
46+
Dependents
Just myself to take care of
I have kid(s)
Does my spouse count?
I have other dependents not listed
(For my marketing purposes only, totally optional) Household Income
<40k
Between 40k and 60k
Between 60k and 80k
Between 80k and 100k
>100k
How'd you hear about me?
Facebook
Instagram
YouTube
TikTok
Email/Text
Other
What social media platform do you use most of the time?
Facebook
Instagram
Tiktok
YouTube
Other
None if I can help it
Do you have a FB account in order to join the Group if I invite you?
Please Select
Yes
No
What motivated you to join this 4 - week challenge?
What's the biggest challenge you're facing right now around not taking better care of yourself?
On a scale of 1 (not commited) - 10 (very commited), how ready are you to commit time and energy to prioritizing yourself right now?
What could potentially get in the way of you showing up for the full 4 - weeks?
Remember, you get your $50 investment back if you complete the assignments and 2 1:1 calls and engage positively with other challengers throughout the timeframe of the challenge.
Are you open to receiving direct feedback and coaching, even if it challenges your current habits or mindset?
Yes
No
Maybe
Have you ever invested in coaching before? And if so, what was it and what was the outcome?
When you complete this challenge with great results, will you be open to exploring more in-depth support options?
Yes
No
Maybe
If you could wave a magic wand and get your ideal result, what would that look like in your life right now?
Submit
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