21-Day Programs Application Form

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21-Day Program Application Form

Thank you for your interest. The intent of this application is to offer the best experience on your 21-day journey

Contact information

21-Day Program Application Form

Name *

First

Last

Email *

Mark what is appropiate about your personal development. I have participated in: *

Individual coaching / therapy
Group coaching / therapy
None of the above

Are you a Be2Be-Coaching client or have you taken any of our classes or workshops? *

Yes
Through a complimentary session
Coaching sessions / program
Course / Workshop
No

The following questions will allow us to define the program that best supports your personal development. Our inner invisible wounding work as programs in our human software, choose the ones you would like to work on: *

Abandonment
Betrayal / Treason
Lack of justice
Humiliation
Rejection

Re write them in order of importance to you:

1. How do you handle your emotional overwhelm?

2. What are the messages you recall that you received in your upbringing around emotions?

3. Blockages to your natural intentions: Do you have any positive intention that you find it hard to believe is posible. Is there anything that you want or not want only to notice that you manifest the opposite?

I would like to receive more information when workshops and courses become available

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