Application Form

Hello beautiful soul,

Working with me is only for spiritually mature individuals who are deeply devoted to their spiritual path and willing to do what’s required for real growth, expansion, and transformation.

My work is for those who are ready to face themselves fully and not just talk about their problems or gather more insight.

It’s for people who’ve already tried therapy, self-help, or surface-level spirituality and realized that none of it touches the deeper layers of their being.

I work with those who are done looping in the same patterns and are ready to get to the root energetically, subconsciously, at the levels of the soul and highest consciousness.

If you feel the pull, even if you don’t know why, and you’re ready to go all in, you’ll know. That’s where we begin.

Filling out this form will help bring clarity to your goals and give me insight into what you’re currently moving through. Please be detailed. I only schedule 15-minute calls with those who complete the form fully and thoughtfully.

Please note: This work is deeply spiritual, energetic, and rooted in the subconscious, soul, and higher consciousness. It is not therapy or clinical mental health care.

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Email *
Today‘s date *
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First and Last Name
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Age
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Phone number (including country code if outside the US)

(I may use your phone number to notify you that I responded to your application via email. At times, my emails are filtered and not found.) 
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Where in the world are you located?
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I am interested in the following (select all that apply):
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Required
How did you hear about me? If someone referred you, please state their name. *
What are your reasons for seeking me out? What do you need support with? (Be detailed.)
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What are the 3 biggest challenges right now? *
What are your top 3 goals for the next 3 months?                 *
What's your big vision for your life?                 *
What do you desire to experience in your life, career, or relationships NOW?               *
What do you believe is stopping or holding you back from having/experiencing what you desire?  *
How would you describe your relationship with yourself?  *
Select all boxes that apply to you.
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Required
Have you ever invested in support before? (either private 1:1 support or group or therapy, etc?) If so, how was your experience?   *
On a scale from 0-10, with 0 being not committed at all and 10 being as committed as I can be, how committed are you to your personal and spiritual growth, transformation, self-actualization and self-realization? *
Why do you believe we would be a great fit for working together? *
On a scale 0 to 10, how motivated are you to work with me?  (0 - no motivation at all, 10 - as motivated as I could possibly be) *
No motivation at all
I'm 100% ready and commited to myself, my healing and transformation.
On a scale 0 - 10, how motivated are you in accomplishing your goals? (0 - no motivation at all, 10 - as motivated as I could possibly be)
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No motivation at all
I'm 100% ready and commited to myself, my healing and transformation.
On a scale 0 - 10, how willing and motivated are you to implement recommended action steps to further your process outside of our session/s? (0 - not willing and motivated at all, 10 - as willing and motivated as I could possibly be)
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No motivation at all
I'm 100% ready and commited to myself, my healing and transformation.
On a scale 0 - 10, how open are you to receive information and feedback, even if challenges your comfort zone? (0 - not at all, 10 - as open as I could possibly be).
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Not open at all
As open as I could possibly be
On a scale 0 - 10, how willing are you to take responsibility for your own growth and transformation (0 - not willing at all, 10 - as willing as I could possibly be)
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Not willing at all
As willing as I could possibly be
How willing and able are you to invest in yourself and your transformation NOW?
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How much are you currently able and willing to invest in yourself for high-level private coaching and mentorship monthly? (Enter an amount in USD. Yes, this is required!) Payment plans are available through a third-party application process if needed.
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If we decide to work together, how soon are you looking to get started working with me? *
What days and times are you available for sessions? (select all that apply). *
Required
Is there anything else that I should know?
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Thank you for completing this application.
If we are a match based on your application, you will receive an email with the next steps.

By submitting this application you are agreeing to be added to and subscribing to Agnieszka "Angie" Navarrete's and Quantum Gateways' email list for further steps, exclusive offers, connection and more.

To ensure email delivery, please add quantumgateways@gmail.com to your email whitelist. I recommend that you briefly message me. Otherwise, check your spam and promotion folders for my email. 
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