Asclepius Movement Application
Welcome to the application to be apart of the Asclepius Movement, a community dedicated to empowering individuals and fostering positive change in their lives. We believe in the transformative power of collective support and self-improvement in various ways. Your journey to a better life starts here. Take a few moments to complete this brief questionnaire, allowing us to understand your aspirations and if you qualify to contribute to our movement.
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Email *
Name: *
Tell us about yourself: (Briefly describe your background, and what motivates you to be apart of the Asclepius Movement) *
What positive changes do you hope to achieve in your life through the Asclepius Movement? (Describe the specific goals and improvements your seeking)
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On a scale of 1-10: 10 being fixing your current situation your #1 priority in life - where would you say you're currently at?  *
What other solutions have you tried in the past to fix your current growth issues? 
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What do you think is missing from achieving your overall growth? (Support, clear instructions, guidance, structured plan...etc.) 
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Are you able to be coached to enhance your skills and knowledge without being set in your own ways?  *
Being part of this community and investing in your personal growth involves a financial commitment. Are you currently in a position where you can comfortably afford a commitment of at least $75 per month?
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How did you hear about the Asclepius Movement?
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Is there anything else you would like us to know about you? (Feel free to add any additional information you believe is relevant to your application.)
A copy of your responses will be emailed to the address you provided.
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