This application helps determine if it’s the right fit for where you are right now. Answer honestly. Clarity and execution matter here.

Full Name *

Contact Information *

Email *

1. What is the primary goal you want to make real progress on in the next 3 weeks? *

2. What’s been stopping you from executing on this goal up to now? *

4. What would make this 3 weeks a clear “win” for you? *

5. This group requires personal responsibility and follow-through. Are you willing to do the work between sessions without reminders? *

Yes

No

6. Why is now the right time for you to do this work? *

7. Are you willing to participate actively in a group environment? *

Yes

No