Private Mentorship Application with Autumn 🤍
Share what you’re ready for, your timing, and your investment readiness so Autumn can review fit and availability.
Applicant Information
Full Name
*
First Name
Middle Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Instagram / Social Handle
Mentorship Fit and Current Situation
What is happening in your life right now that has you feeling called to private mentorship?
*
What are you most ready to change, heal, create, or step into over the next 3–6 months?
*
What feels like the biggest thing keeping you stuck or making this difficult to do on your own?
*
Why do you feel called to work specifically with Autumn?
*
Desired Outcome and Support Preferences
What would feel different in your life by the end of the mentorship if it were deeply supportive and successful?
*
Which type of support are you most interested in?
*
Private Mentorship
Heart Restoration + ongoing support
I’m not sure yet
What is your preferred timing?
*
As soon as possible
Within 30 days
Within 1–3 months
I’m planning ahead
I’m flexible
Investment Readiness and Commitment
Private mentorship is a paid, high-touch investment. If we both feel this is aligned, which best describes your readiness to invest?
*
I’m ready to invest now
I may need a payment plan
I’m interested but need to understand the options first
I’m not financially ready yet
Are you willing to take action, be honest with yourself, and participate actively in the coaching process?
*
Yes
No
Additional Notes and Consent
Is there anything else you want Autumn to know before reviewing your application?
Consent acknowledgement
*
I understand that submitting this application does not guarantee acceptance or immediate availability, and that private mentorship is not a substitute for medical, mental health, legal, or financial care.
SUBMIT MY APPLICATION
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