motherwell one-on-one coaching application form Full Legal Name * First Name Last Name Preferred name/nickname * First Name Last Name Email * Phone * (###) ### #### Billing Address * Address 1 Address 2 City State/Province Zip/Postal Code Country How did you hear about MotherWell Coaching? * Please explain why you are interested in one-on-one coaching with Kristen. * What kid of emotional, energetic, or integrative healing work on yourself have you done up to this point? * What have the results been? * What are you hoping to accomplish in your 4 months of coaching and deep inner work with Kristen? * How do you feel about the present version of yourself? What do you think when you look in the mirror, and what are some big areas you'd like to explore in coaching with Kristen? * Describe a picture of what your future self looks like. What new skills do you have? How can you navigate stressors or triggers? How does future you take care of herself? How does she feel in her body? Be specific! This is a part of your vision for what we will work on in the coaching space. (Hint: this future version of you already exists within your spirit and DNA, and our coaching objective is to help you ACTIVATE it!) * Are you willing to invest time in yourself physically, emotionally, and spiritually to contribute to your self mastery skills? * Yes No Maybe Are you willing to explore not just the imbalances and shadow parts of yourself, but your amazing potential, light, strengths, and greatness? * Yes No Maybe I am willing to explore radical self honesty so I can have comprehensive balancing of body, spirit, and soul as well as expansion of your own skills. * Strongly Disagree Disagree Neutral Agree Strongly Agree I understand that this coaching opportunity extends for a duration of 4 months, which includes 4 90-minute monthly coaching sessions and voice and video messaging with Kristen on WhatsApp. * Yes No I understand that the total promotional cost for this coaching package is $1644 USD. If my application for this opportunity is approved, I choose to pay from one of the options below. * Yes No Please select the payment option you would like to choose. * Pay full mentorship cost of $1644.00 Split into 2 payments of $822.00 Pay $411 deposit and then 3 monthly payments of $411 Please type your full name here as a digital signature. * I understand that this coaching package is non-refundable. If for some reason, I no longer desire to continue coaching with Kristen, I am still financially obligated to pay out whatever balance is remaining of this package. If I have paid the full balance of the package, I understand that I will not receive a refund. I am aware of this and agree to this. * Yes No I understand that the extent of my growth and success in this coaching container is entirely up to me. I am responsible for my own participation and the application of what I learn. The way that I use the techniques and principles from this mentorship is not Kristen's responsibility. It is my own. * I agree I disagree Thank you for your submission! You will hear back from Kristen within 1 week of submission. Please check your spam folder if you’re wondering if she has responded.Peace and Health to you!
