Clone of The Nine Centers Mystery School

1

Your Name* This field is required.(First and Last)

2

Email Address* This field is required.

example@example.com

3

Phone Number

Please enter a valid phone number.

4

Tell me a little bit about where you are right now in life* This field is required.(Work, family, or personal context - whatever feels most important to share)

5

What feels like a bold change or shift you've been putting on the back burner, but just can't ignore anymore?* This field is required.

6

What specifically drew you to this space at this time?* This field is required.

7

Why are you ready to make a change now? What's different?* This field is required.

8

What are you hoping to experience, learn, or create during our time together?* This field is required.

9

Have you worked with your Human Design or Gene Keys before? If so, in what way(s)?* This field is required.

10

What feels like the biggest challenge or pattern you keep running into that you'd love support with?* This field is required.

11

What type of support feels most helpful for you right now?* This field is required.

Accountability

Human Design Guidance

All of the Above

Other (please list below)

12

If you answered 'other' in the previous question, please list what else would feel most supportive for you right now.

13

This is a space for women ready to make moves, not just think about them. What's one bold step you know you're ready to take in the next six to twelve months?* This field is required.

14

Birth Date* This field is required.(So I can pull your human design chart)

15

Birth Time* This field is required.(So I can pull your human design chart)

16

Birth Location* This field is required.(So I can pull your human design chart)

17

Are you financially ready to invest in The Wild Woman Portal at this time?* This field is required.

Hell yes! Pay in Full ($3,000)

Hell yes! Payment plan (3 monthly payments of $1,000)

Hell yes! Payment plan (4 monthly payments of month $750)

I'm financially ready, but I still have questions before signing up