Application Form - 12-Month Coaching with Clare
Thank you for your interest in my signature 12-month coaching package. This brief application helps me understand if we're a good fit and ensures I can support your journey.
Your details
I'd love to know a little more about you.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Your location (city/region)
*
Your astrological details
(Essential for this work.)
Birth date
*
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Month
-
Day
Year
Date
Birth time
*
Hour Minutes
AM
PM
AM/PM Option
Birth location (city/country)
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Your journey
What's bringing you to coaching with me right now?
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[What's happening in your life that makes this the right time for a 12-month commitment?]
Which of these feels most true for you? (select all that apply)
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I'm burning out before my harvest is ready
I'm wasting energy planting seeds in the wrong season
I'm missing the flow that makes growth feel effortless
I keep pushing uphill when life is asking me to rest
I'm struggling to see results despite working hard
Which package tier are you interested in?
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🌾 Harvest Package - $300/month ($3,600 total)
12 coaching sessions + 6 healing sessions + messaging support
🌿 Growth Package - $225/month ($2,700 total)
12 coaching sessions + 3 healing sessions + messaging support
🌱 Seeds Package - $130/month ($1,560 total)
12 monthly coaching sessions
I'm not sure yet - I'd like to discuss options
This is a 12-month commitment. What makes you ready to invest a full year in working with your natural rhythm?
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Next steps
Preferred session format:
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In-person at Be Different Studio, Napier
Online via Zoom
Either works for me
How did you find me?
*
Instagram
Facebook
Website/Google search
Referral from a friend
I've worked with Clare before
Other: [text field]
What happens next
Once I receive your application, I'll review it and be in touch within 1-2 business days. If we're a good fit, I'll send you booking details and your comprehensive intake form to prepare for our first session together.Looking forward to connecting,Clare
Check 'Yes' if to receive your quiz results and future emails from Clare - you'll also receive free sovereignty resources and subscriber-only offers delivered to your inbox. You can unsubscribe anytime.
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Yes
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