Interest Form
So you've decided you want to overcome social anxiety, achieve your goals and build connections. Yay! Complete the form below and we'll be in contact. 

There's no obligations with this form, you're just saying you're ready to learn how we can work together and learn more.
Name *
Email *
Mailing Address
Phone number *
What is one Personal Goal you're determined to accomplish? No goal is right or wrong, it's meaningful simply because you wish to achieve it! *
What is one Connection Goal you're determined to accomplish? This can be connection with yourself, current or new friends, animals, plants, etc. The sky is the limit.  *
About how much time per week do you want to commit to making progress on these goals? *
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