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Cell Phone & Skype ID (If Non US Resident, Input Skype ID)
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What is the name of your organization and who do you serve?
What is your role within the organization?
What are the ways you would like your organization to feel inspired, learn or grow in?
What fixes or solutions have you tried in the past? How did they help? How have they not helped?
What is the theme and purpose of your gathering?
Place a check mark next to the top areas that you feel that your organization needs the most help with:
_Health and wellness
_Being a “control-freak”, "perfectionist", "procrastinator" or "people-pleaser"
_Focus and intention
_Discovering passion and purpose
_Seeing the big picture/strategy
_Not being able to let go of my past
_Forgiving people that hurt me
_Other – Please explain
My programs work best with heart-centered, evolving and emerging influencers - leaders who are ready to invest in themselves, discover who they are at their core and live with intention. Why do you feel your organization is a good candidate to be considered?
A copy of your responses will be emailed to the address you provided.
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