PRIVATE RESTORATION SESSION APPLICATION
Thank you for your interest in a Private Restoration Session with Chaka Y Jackson. This one-time, 75-minute virtual session is designed for believers who need biblical clarity, prayer, and practical next steps as they return to God, heal, and grow in Christ. Please complete this application honestly and prayerfully. Submitting this form does not guarantee approval or a booked session. If your application is approved, you will receive a private link to complete payment and schedule your session. Investment: $250 Availability: Thursdays, 11:00 AM to 2:00 PM ET, and select Saturdays, 10:00 AM to 12:00 PM ET. Please review the current session availability before applying. I am not able to accommodate additional days or evening sessions at this time.
Applicant Information
First and Last Name
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First Name
Last Name
Email Address
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example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
State / Country
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Restoration Need and Spiritual Condition
What led you to apply for a Private Restoration Session at this time?
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What is the main area you are hoping to receive clarity, prayer, or guidance around?
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What do you believe may be keeping you stuck, distracted, or disconnected from God?
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What are you ready to surrender, confront, or change in this season?
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What do you hope to receive from this session?
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Which best describes where you are spiritually right now?
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I feel spiritually stuck.
I feel distant or disconnected from God.
I am returning to God and need support.
I need biblical clarity and direction.
I am struggling with obedience or consistency.
I feel weary or spiritually drained.
I am repeating patterns I want to break.
I need prayer and practical next steps.
Other
Willingness and Additional Notes
Are you willing to receive biblical guidance, prayer, and practical next steps, even if it challenges you?
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Yes.
I believe so.
I am unsure.
Is there anything else you would like Chaka to know before reviewing your application?
I understand this as a standalone private restoration session.
I understand this is a standalone private restoration session
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I understand this is a stand-alone Private Restoration Session and does not include ongoing access, follow-up messaging, or continued mentorship after the session. If Chaka sends session notes, Scriptures, reflection prompts, or next-step resources afterward, I understand that those are provided at her discretion and do not create an ongoing mentorship relationship. If I wish to schedule another session in the future, I understand I will need to submit a new application, subject to availability and approval.
Not Therapy or Crisis Care Acknowledgment
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I understand this session is not therapy, counseling, crisis care, or a replacement for professional mental health support.
Payment Acknowledgment
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I understand the investment for the Private Restoration Session is $250, and full payment is required before my session is scheduled.
I understand that all payments are non-refundable once payment has been submitted.
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I understand that all payments are non-refundable once payment has been submitted.
I understand that submitting this application does not guarantee approval or a booked session. If approved, I will receive a private link to complete payment and schedule my session.
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I understand that submitting this application does not guarantee approval or a booked session. If approved, I will receive a private link to complete payment and schedule my session.
Submit Application
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