Her Elevated Self

Her Elevated Self 5-Month Coaching Programme Application

Please fill in this form to apply for this programme. Suitable candidates will be selected upon receipt of a completed application. You will receive a response in your inbox within 72hrs.

Name

Age

What is your marital status?

Mobile number (including country code)

Country of residence

Why would you like to join this coaching programme?

What patterns of codependency do you identify in yourself?

Have you had coaching or counselling before? What was your experience?

What are you specifically struggling with right now that you need support with?

What 3 goals would you like to achieve by the end of this 5 month programme?

What does the best version of you look and feel like?

What date & time suits you best for coaching sessions?

Monday evening from 8.30pm Tuesday evening from 8.30pm Wednesday evening from 8.30pm Tues, Wed, or Thurs daytime between 10am - 4pm Saturday evening from 8.30pm Sunday evening from 8.30pm

Have you read the programme details?

I have read the programme details.

Are you ready to invest in yourself for this transformation?

Yes, I'm ready! No, I'm not ready