Apply For DLC Services Today!

Thank you for your interest in the programs offered through Dwayne Lemon Consulting.

This brief application helps us understand your situation and determine whether our programs may be a good fit for your needs. Completion of this application does not guarantee acceptance into any program or scholarship opportunity.

Please answer each question honestly.

Section 1: Contact Form

First Name *

Last Name *

Email *

Phone *

Section 2: Program Interest

Which area are you seeking support in? *

Marriage Restoration

Mental & Emotional Wellness

Sexual Integrity & Addiction Recovery

Not Sure Yet

Section 3: Readiness For Change

Are you actively seeking help because you want things to change now? *

Yes

Which best describes your current level of commitment? *

Just gathering information

Interested but undecided

Serious about making changes

Ready to begin immediately if accepted

Section 4: Coaching Alignment

Do you understand that our coaching process incorporates biblical principles and Christian values? *

Yes

Section 5: Financial Readiness

If accepted into the program, are you willing and financially prepared to invest in your healing and growth? (Most programs begin at approximately $2,500+.)

Yes, I am financially prepared.

I would need financing options.

Not at this time.

If accepted, when would you be prepared to begin?

Immediately

Within 30 Days

Within 60 Days

More then 60 Days

Section 6: Your Story

Briefly share why you are seeking support at this time. *

Maximum 200 characters

Section 7: Final Agreement

Please acknowledge the following: *

I understand lasting change requires personal responsibility.

I understand coaching requires effort outside of sessions.

I understand there are no guarantees of specific outcomes.

I am willing to actively participate in my own growth and healing.