Sacred Body Confidence Mentorship Application
Hi love!

I am so happy you have considered joining our mentorship program. As much as this program has the benefits of giving you the tools for creating confidence in your body... this is a ultimately a process of LEARNING, EXPLORING and RE-DISCOVERING YOURSELF :)

So I ask that you take the time to fill out this application form to be part of the program. This program that I have designed is both an UN-learning of old patterns, beliefs and ways of being... into a REMEMBERING of the wisdom and confidence we were born with.

This program asks for commitment, compassion and self forgiveness every step of the way. And as much as I am here to provide to you the knowledge and the wisdom you need... my support and the community we create together is meant to remind you that you ALREADY have the wings you need to fly <3

Fill out the form below and I look forward to contacting you soon!

Qualifying applicants will receive a 30 minute Master You Body Confidence Game-plan Session with me to ensure we are a perfect fit, free of charge.

Much Love,
Q. Char

Session Pricing begins at $160 CDN per week including:
*Weekly 1:1 Sessions are 60 - 120 minutes total (in-person/online/phone)
*Supplementary resources, Pre-recorded Movement videos (Yoga, Dance & Breathwork), journal prompts and assignments
*Check ins and updates will happen via Voxer (communication app) throughout the week.
Sign in to Google to save your progress. Learn more
Email *
First & Last Name: *
Phone Number
Instagram handle
Other socials (if applicable)
Who are your biggest inspirations when it comes to body confidence and authentic expression? *
What comes to mind when you think of Body Confidence? *
On average, how many days a week do you dedicate to self-care? *
0 Days a week
On average, How many days a week do you dance and freely move your body? *
0 Days a week
What is your vision when it comes to your self expression in this world? Your sense of purpose? And how you feel in your body? *
Have you made any action steps create your vision? If so, what have you done? *
Do you have any fears when it comes to manifesting your vision? If so, what are they? *
Where do you think these fears and/or insecurities come from?
What is the ultimate solution you think you need to overcome these fears and/or insecurities?
What do you think your life would look like having overcame your fears or doubts? *
The mentorship program involves use of online and/or in person meet ups, are you willing to schedule the time out to attend consistently? *
What is your current work schedule like? *
Do you have a computer or phone to access Zoom and Voxer (communication app)? *
Are willing to show up for yourself, even when its uncomfortable and out of your norm? *
A copy of your responses will be emailed to the address you provided.
Clear form
Never submit passwords through Google Forms.
This form was created inside of InnerVerse Connect. Report Abuse