Application | Coach Wanda Marie

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Mentorship Application

Today's Date*

Applying For:*

First name*

Last name*

Phone*

Email*

Date of Birth (must be over 18)

Month

Day

Year

Full mailing address (including zip code/region)*

Relationship Status*

Single and Happy

Single and Looking

Married/Life Partner

Separated/Divorced/Widowed

Religious Background and are you currently active?*

What is the most significant thing going on in your life right now?*

What is your main level of Awareness?

Dreamer: Asleep (I'm totally new to this stuff)

Creator: Eyes Opened (I'm creating great parking spaces)

Seeker: Aware (I'm learning to create the life I want to live)

Servant: Fully Awake (I'm learning to love more, let go and surrender)

Check ONLY the boxes that are a "YES" for you.*

I can be relied upon to be on time for all sessions.

I am willing to be on camera and fully participate in the sessions.

I will do my best to complete all assignments on time.

I am willing to share openly and honestly my thoughts and feelings.

If in a group program, I will hold sacred the group's sharing.

I will take full responsibility for my journey and experiences.

I have adequate funds to pay for my training and will not suffer.

I get that this is an act of self-love and personal commitment to me.

How did you hear about us?*

Anything else you would like us to know about you?*

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