THE CELEBRITY FORMULA APPLICATION

Please fill out this form completely to be considered for The Celebrity Formula.

Based on your answers, if you look like a good candidate for the program, then we will reach out via email to have you book a 15-minutes consultation call with Dana personally.

The next session starts on Monday, December 2, 2019.

Name*

First NameLast Name

Email*

example@example.com

Your Website (if applicable)

Links to your preferred social media profiles and/or pages:

If you were selected for the program, could you attend live calls on Mondays? (Check all that apply.)*

Yes. Mondays at 11 AM Pacific TimeYes. Mondays at 1:30 PM Pacific TimeNo. Mondays don't work for me, but I could do another day of the week.I wouldn't be able to attend sessions live during daytime hours, but I could listen on replay.I'm not sure about this yet.

Tell us a little bit about your business:*

Where would you like to be in your business? (What would you like to achieve?)*

Why would you like to be a part of The Celebrity Formula?*

Is there anything else we need to know?*

Are you prepared to invest $3997 for the 9-Week Course? (NOTE: If you have already invested in Train Your Brain for Influence, then you will receive a $1,000 discount on The Celebrity Formula.)*

Yes, I am prepared to make that investment.Yes, but I would like a 2-pay option, if you have it.Yes, I am in the U.S. and could use Paypal's six-payments, interest-free option.No, I do not have the money to invest in this course at this time.Other