The Living Room Within
Please fill out the form with your details to apply for the program.
Full Name
*
First Name
Last Name
Pronouns
*
Email Address
*
example@example.com
Your Time Zone
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Briefly introduce yourself: what do you love, what makes you "you," what makes you come alive, what are some patterns you've noticed?
*
What is the biggest part of your life you're wanting more clarity/peace in?
Relationships
Financial/Wealth
Health
Spirituality
Career
Aging/Indentity
Other
What attracts you to this program?
*
What are you hoping to gain/learn/experience by participating?
*
What are the best times for you to attend a monthly live coaching session (EST)?
*
Monday evening
Tuesday evening
Wednesday evening
Thursday evening
Tuesday afternoon
Wednesday afternoon
Thursday afternoon
Wednesday mornings
Thursday mornings
How likely are you to commit to "doing the work" over the next 3 months?
*
Bare minimum
1
2
3
4
All in
5
1 is Bare minimum , 5 is All in
Is there anything more you would like to share?
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