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Rebuild U - 3 Month Coaching Interest Form
WHO THIS IS FOR: People who want to rebuild and reclaim themselves and their lives. If you have been struggling with Self-Love and in Relationships and you're tired of this struggle...this coaching is for you!
STARTING DATE: Coaching Begins January 6, 2020
DETAILS: Weekly Zoom calls. Coaching on hot topics picked by you or the group, coaching on challenges, identifying goals, and meeting those goals. Individual Sessions - Limited Available!
* Required
Email address
*
Your email
Name
*
Your answer
Phone
*
Your answer
Relationship Status
*
Choose
Single
Married
Separated
Divorced
Complicated
What is going really well in your life right now?
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Your answer
What are the challenges in life?
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Your answer
What do you want to change, reclaim, or rebuild in your life?
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Your answer
Are you ready and committed to having lasting change in your life?
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Yes
No
Not Sure
Required
Are you able to invest in this 3 month coaching program and pay monthly payments or full price?
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Yes
Not At This Time
Possibly
If Yes, will you be paying monthly or full price?
*
Choose
Monthly Payments of $416 (Paid on the 5th for 3 months)
Full Price $1200 and save $50 (Paid prior to starting)
Two Payments of $600
What do you want to have accomplished by the end of this Coaching Program?
*
Your answer
Thank You For Your Interest!
Your submission will be reviewed and I will reach out to you shortly. If you have any questions in the meantime, feel free to email me at
kari@passion4visions.com
.
Send me a copy of my responses.
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