First Name

Last Name

Teens Name First & Last (if different)

Teen Bday

Email *

Phone *

Which City & Time Zone Are You In?

How did you hear about us?

What is the #1 concern that you have right now for your teen?

Background with public or homeschool education. What grade?

Has there been a specific incident that has happened that has caused this concern or has this been going on for quite some time?

What is the #1 concern that you have right now for yourself?

Be 100% honest - what do you think is stopping yourself or your teen from getting results?

Name your top 2 goals for yourself or your teen that you are fundamentally committed to achieving in the next 6-12 months

What is the PAY OFF for achieving these goals? How is your new life going to be different for both you and your son or daughter?

Trainings require about 1.5 hours a week to implement. Is this realistic for yourself or your teen right now to make the time for their personal growth?

Are you committed to work alongside Addie and Claudia and hold yourself or your teen accountable with the strategies they give you both?

Yes

No

Maybe

Right now I...

Have the financial resources to invest in myself or my son or daughter's personal growth

I don't have any financial resources at all and I'm going to things with where they are at

Any Additional Info. Thanks! :)