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Pure Abundance Retreat Belize
We are so excited that you are feeling called toward the Pure Abundance Retreat. Please fill out the following questionnaire so we can get to know you better before our Introductory Call.
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Name
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Your answer
Phone Number
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Your answer
Email Address
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Your answer
Age Range
*
25-30
30-40
40-50
50-up
Marital Status
*
Married
Single
Widow
Domestic Partnership
Do you have children?
Yes
No
Clear selection
How many children?
Your answer
What is your career?
Stay at home mom
Employee
Unemployeed
Corporate Professional
Entrepreneur
Clear selection
Have you recently experienced a life change/shift that has left you wondering “What Now?
Divorce
Marriage
Loss of a loved one
Childbirth
Empty Nest
Passed over for a promotion
Weight Gain
Weight Loss
Loss of job/career
Clear selection
Explain.
Your answer
Do you feel like youʼve lost yourself in the process?
*
Yes
No
Has your recent transition brought you to a place of seeking positive change?
*
Yes
No
Have you invested in coaching, workshops, or personal development in the past?
*
Yes
No
Are you ready to take action now?
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Yes
No
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