First Name
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Last Name
Phone
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City
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State
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Email
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Date of birth
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What's your biggest challenge right now?
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Where do you want to be in the next 90-180 days?
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Why aren't you currently there? What do you think is the biggest thing stopping you right now (that you can see or know of)?
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On a scale of 1-10 how willing are you able to financially invest in your personal and spiritual growth? (1 being not willing, 10 being most willing)
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Please tell us WHY you are inspired to apply and journey.
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How did you come across JPK's work?
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