What is the main reason you'd be interested in changing - or escaping - your career?
*
Yes
No
Would you love to learn to help yourself while making a positive impact on the world?
*
Yes
No
Are you an existing coach or mental health professional?
*
Yes
No
Are you looking to transition to becoming a therapist as a full-time career?
*
Yes
No
Is there anything you'd like to tell us about your background that's relevant to a potential career as a therapist? (Optional)
What appeals to you most about a career as an RTT Therapist?
*
Yes
No
Which element of your personal circumstances would improve the most if you worked for yourself as an RTT therapist?
*
I could spend more time with my family & friends
I would have less stress
I would have more freedom to live the life I choose
I would be able to earn more money
What blockers have stood in the way of your starting a new career that you most want our help with?
*
Self-Doubt, lack of confidence - I'm not sure I can do what's necessary to succeed
Lack of Focus - I get distracted by other less-important elements of work or life
No follow-through - I struggle to commit to the actions I know I need to take
Procrastination - I struggle to take the action needed to succeed
Lack of qualifications - I don't feel I have the necessary skills or knowledge
Nothing - I know that with the right training I can succeed
How much time are you able to commit PER WEEK if it means becoming a cutting-edge RTT® therapist in the next 6 months?
*
1-5 Hours Per Week
5-10 Hours Per Week
10+ Hours
Are you committed to becoming a student for 6-9 months to transform the lives of others and create a profitable new career for yourself?
*
Yes
No
What would you need to earn as an RTT® therapist to replace your current income?
*
I'm currently unemployed
Zero - $30,000
$30,000 - $60,000
$60,000 - $100,000
Over $100,000
Which RTT service most interests you?
*
Training Live with Marisa
Training Online from my Home
I understand that in order for my application to be considered and approved, I must book a time to talk with an RTT® application advisor on the next page.
*
Yes
No
What is your First Name?
*
What is your Last Name?
*
What is your Email Address
*
What is the phone number you wish us to call you on?
*
In which country are you based?
*
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, The Democratic Republic of the
Cook Islands
Costa Rica
Cote D"Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and Mcdonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic Of
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People"S Republic
Korea, Republic of
Kuwait
Kyrgyzstan
Land Islands
Lao People"S Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia, The Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Moldova, Republic of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory, Occupied
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
UK
Ukraine
United Arab Emirates
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
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Have you taken one of Marisa's trainings before?
Yes
No
Which training/s did you take?
An RTT Foundation Course
An RTC Coaching Course
One of the 21-Day Challenge's
Practioner Marketing
Confident Coach
One of her Personal development Programs (eg. I Am Enough)
One of her Health Programs (eg. Dietless Life, Perfect Weight Forever)
Is there anything else you'd like us to know, or discuss with our team? (Optional)
Please verify that you are human