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 *
Your answer
Date *
MM
/
DD
/
YYYY
Email *
Your answer
1. Your gender: *
2. What's your age range? *
3. What's your current monthly income (in USD)? *
4. What's your job title? *
Your answer
5. Why are you unable to pay the full fee for healing & coaching with Christina? Please explain your financial situation better. *
Your answer
6. What fee are you able to contribute toward a coaching/healing session? *
Your answer
7. What else do you wish to add to your application? *
Your answer
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.
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms