UNITY Application

OFFICIAL UNITY APPLICATION
Instructions:

Please answer the questions below and on the following pages to the best of your ability.
Your Full Name *
Phone Number *
Address *
City, State, Zip *
Country *
Email *
Occupation *
Date of Birth *
Gender *

Female Male
Marriage Status *

Married Single Divorced Widow/Widower

Continued Application for
UNITY
5. What are you most proud of and excited about in your life?
6. What negative recurring thoughts, fears, or behaviors would you like to overcome in order to feel more psychologically free, confident and successful?
7. What eating, exercise or general health habits would you like to begin or break in order to feel stronger and more healthy physiologically?
8. What distracts you the most from being more productive, and what major projects or missions are you struggling to complete faster or more efficiently?
9. How purposeful do you feel in living each day, and how would you describe your purpose?
10. If you were more persuasive or influential, what dream or desire would you ask others to support you in achieving?
Should be Empty: