Breakthrough Session Application

Full Name*

PrefixFirst NameLast Name

Date of Birth ____________________Time _____________ Place ____________________

Email

example@example.com

Phone Number

Area CodePhone Number

Date

What are your deepest aspirations and professional visions for the remaining of 2022?

What is something you are celebration in your life and accomplishments right now?

_________________________________________________________________________

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What areas in your personal or financial life need more clarity, confidence, or cash flow?

__________________________________________________________________________

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CHECK ALL THAT APPLY : What is your next level personal or professional vision?

I am curious and interested to learn more about the quantum homeopathic Practitioner Training to increase my income and impact.I want to expand my professional network of high caliber of connections and collaborations.I want to turn my existing message, offering, mission into even greater profit & potential.I want to be a guest of A Podcast or Signature Virtual Talk Show.Other ______________________________________

What is the priority foundational breakthrough you want to get out our call together?

What are some of your goals, aspirations or dreams that you've been pushing off, procrastinating or perhaps sabotaging? Any particular reason?

What do you think is your special SuperPower Gift? From 1 to 10. How well do you prioritize and embody it?

Where do you most want yourself to be in a year from now and in 5 years.

Date