Application for 3-Month Breastfeeding Mentorship
Once you submit this form, your responses will be reviewed same business day (or next business day if after business hours). We will then be in touch with you to set up scheduling and payment.
What is your first name? *
Your answer
What is your last name? *
Your answer
What is your email address? *
Your answer
Please describe the biggest challenge you are facing either with breastfeeding that you would like support with.
Your answer
Are you:
How would you rate your understanding of breastfeeding (latch, milk production, diet, infant oral function) on a scale from 1-10 - 1 being very poor (I know nothing!!) to 10 being extremely confident (stellar knowledge level)
Please list below any previous books, courses, or other information products you have used to learn about breastfeeding (i.e. Womanly Art of Breastfeeding, websites, blogs, etc.)
Your answer
What are you hoping achieve by the end of our time working together?
Your answer
Which time zone do you live in? *
Your answer
Please indicate your preferred payment schedule: *Please note that payment is required to secure your spot in the program upon registration *
Please provide your telephone number:
Your answer
Where did you hear about Jacqueline Kincer/Holistic Lactation?
Your answer
Thank you for submitting your application and joining the waiting list! If you have questions please email me at: hello@holisticlactation.com
Please note that payment (either full or the first installment if you choose a payment plan) is required upon registration for the 3-Month Breastfeeding Mentorship Program. You will be notified as soon as a spot becomes available. Looking forward to working with you! Enjoy the rest of your day! --Jacqueline
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