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Application for Inner Circle
Thank you for your interest in learning about how our community can help you learn to work through the challenges you're experiencing so you can live life on your terms with the confidence you desire. All while embracing your neurodiversity.

Once you've completed the application I'll review the answers and follow up with you regarding next steps.
Email *
First and Last Name *
What is my biggest challenge right now? (Please explain the ways it impacts your life) *
Why am I seeking help now? *
What have I already tried (specifically) to resolve this issue? *
How will I know when I have achieved what I want? *
On a scale from 1 -10 (10 being the strongest) How upset do you feel having this problem? *
How do I feel about working with other people in a support community to solve this problem? *
What do I think I could contribute to the aforementioned community? *
What are my personal goals? *
What am I willing to do to achieve my goals (be specific). *
What are my personal strengths? *
What is holding me back? (e.g. unhealthy relationships, recurring problems, limiting beliefs, unproductive habits, disorganization, etc.) *
What accomplishments am I most proud of in my life and why? *
What I most want to get out of my experience with the Inner Circle? *
How will I know I am getting it? *
Please note any other issue that are important for us to understand about you (e.g. physical, psychological, belief issues) *
Are you employed? *
Marital Status *
Are you ready, willing and able to invest $97 per month (6 month minimum) to achieve your goal(s). *
How'd you learn about me? *
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