Ascension Coaching Form

1

Name* This field is required.

First Name

Last Name

2

Age* This field is required.

3

Where do you need the most help?* This field is required.

Porn / compulsive habits

Inconsistent training

Self worth / confidence

Feeling directionless

Brain fog / lack of focus

Poor body image

Honestly, all of the above

4

In your own words, describe your current situation* This field is required.(Where are you stuck right now?)

5

What have you already tried to change this?* This field is required.(Be honest — routines, programs, self-help, nothing, etc.)

6

Why hasn’t it worked long-term?* This field is required.(What keeps pulling you back?)

7

What made you apply for Ascension specifically — why now?* This field is required.

8

If nothing changes in the next 6–12 months, what does your life look like?* This field is required.

9

What are you willing to do differently this time?* This field is required.

10

Which level of support are you applying for?* This field is required.

Tier 2 - Brotherhood

Tier 3 - 1:1 Mentorship

11

Are you financially & mentally prepared to invest in your transformation if accepted?* This field is required.

Yes

No

12

What’s your Instagram @* This field is required.

13

What’s your Email* This field is required.In case I can't reach you via IG