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Cultural Empowerment Approach to Healing Discovery Questionnaire
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1
First off, what's your email address?
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example@example.com
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2
Great, and what's your name?
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First Name
Last Name
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3
Do you identify as the global majority?
Yes
No
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4
What motivates you to join this offering?
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5
What feels important for you to share about yourself?
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6
What are your preferred pronouns?
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7
What are you hoping to get out of this offering?
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8
Choose your payment plan
Early bird rate of $1111 is available until March 1st, 2026
Single Payment: $1111 ($1400 after March 1st, 2026)
4-Month Payment: $278 monthly ($350 monthly after March 1st, 2026)
6-Month Payment: $186 monthly (available until March 1, 2026)
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9
Do Fridays, 11:00am - 1:00pm ET work for you?
Subsequent meeting dates, every Fridays at 11:00am-1:00pm ET starting May 1st, 2026
Yes
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