Application :: NeuroDefiant Collective

Hello NeuroKin!

Thank you so much for your interest in joining the NeuroDefiant Collective: a monthly group coaching membership!  

We center anti-oppressive, ethical commerce, consent-based, neuroinclusive, accessible, equitable, non-exploitative business practices.  

This application is meant to help you think through your readiness for this space and to help me to know if we are a good fit for doing this work together.  

My intention is to be sure that you get the absolute maximum return on your investment of time, money, and trust.

with wild kindness, 


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Email *
Name *
Pronouns *
Where did you learn about the NeuroDefiant Collective?
Name/s of people you have referred to NeuroDefiant Collective:  This is required in order to get the Referral Program Bonus 30min 1:1 coaching session.
Name of member who referred you to NeuroDefiant Collective:   This is required in order to get the Referral Program Bonus 30min 1:1 coaching session.
What does the word, "NeuroDefiant" mean to you?
What about the NeuroDefiant Collective program attracted you to join?
What do you hope to gain out of joining a community of Neurodivergent & disabled entrepreneurs and professionals? *
How open are you to guidance, to constructive feedback, and to embracing fresh mindset perspectives? *
What are key elements do you need in a community for a sense of safety, belonging, accessibility, and inclusion?

In reviewing the pricing tiers, is this something you are able to financially commit to for 12 monthly payments or a Paid In Full membership?

Membership Pricing: 

Platinum Tier: + 1x monthly 50min 1:1 coaching

Gold Tier: + 1x monthly 30min 1:1 coaching
$4,764/ annual

Diamond Tier: monthly membership group coaching
Do you acknowledge that there are no refunds or transfers of membership fees once your contract is signed? *

Do you agree to abide by the values named below:

The Culture

The NeuroDefiant Collective is a space that centers community values rooted in anti-oppressive, anti-racist, non-ableist, neurodivergent-affirming, growth mindset, restorative justice, and collective care.  All members must agree to abide by these values in all spaces of the NeuroDefiant Collective.

This is a space for growth and learning and there may be times when a gentle teaching is necessary to help others understand terms that are outdated or ableist, etc.

We do not tone-police in this space and I encourage everyone to be present with the best intentions and assume others are acting with the best intentions as well.

If there are concerns about someone's safety, unkind behavior, disregard for our community values, please bring them to me and I will address them.

Please note, this is not a therapy group and I am not anyone's therapist.  I am a coach and this space is considered a group coaching/social support space.

If you have additional questions or want to do a vibe check with me, please feel welcome to schedule a free 20min curiosity call with me by clicking here.   *
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