Financial Hardship Application

We do our best to accomodate your financial challenges and strive to provide services to those who are struggling. IMPORTANT NOTE: please keep in mind that this application is no assurance of working with Christina, as she has limited availability to accomodate all requests. You may be put on a waitlist.

Name *

Today's Date *

YYYY

Email *

1. Your gender: *

Female

Male

Prefer not to say

2. What's your age range? *

<30

30-35

35-40

40-45

>45

3. What's your current monthly income (in USD)? *

<$100

$100-$500

$500-$1000

>$1000

4. What's your job title? *

5. Why are you unable to pay the full fee for healing & coaching with Christina? Please explain your financial situation better. *

6. What fee are you able to contribute toward a coaching/healing session? *

7. What else do you wish to add to your application? *

By checking this box, you're taking an oath of honesty and standing by the truth of the information you've given. *

Please note: you don't want to create negative karma that comes from dishonesty or deceipt. So please make sure the information here is TRUTHFUL.

I stand by the truth of the information I've provided in this application and understand the risks of committing perjury.

Required

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