Lilies Youth Mentorship Application
Hello! Thank you for taking the time to fill out this application so I can learn more about the needs of your daughter. Please consider consulting her for these answers as well to ensure you are on the same page with your shared intentions for our work together.
Email address *
First & Last Name of Parent *
First, Last Name, & Age of Student *
Email of Student if applicable
Where are you located? *
Is the students schooling in person or all virtual right now? *
What is the primary area of focus or reason you are seeking healing or transformation? *
What would you say you struggle with the most currently? This can be emotional, physical or behavioral. *
If nothing were off limits, what huge shift would you like to see happen within you (internally and externally)? *
Do you have funds set aside for this part of your life, personal growth, healing and self realization? *
How did we find each other? *
Is there anything else you'd like to share?
Never submit passwords through Google Forms.
This form was created inside of Aura Awakening. Report Abuse