Apply for a Goal-Wiring and Mapping Session

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You are applying to get a Private Mapping Session. These sessions may include Customized Conscious/Unconscious Mind Aligning Work, Goal Alignment Work, Family Entanglement and Childhood Imprint Mapping, and more. For all the questions below, you can answer in bullet points, you don't need to write paragraphs. Shorter answers are fine. :)

Name *

Email *

What is your Biggest Goal? *

In Business and/or in Life?

What are your Biggest Problems/Obstacles in the way of reaching this goal? *

If you own a Business, what is Your Business?

Who do you serve, what problems do you solve, what products or servcies you you provide?

What are some other Short Term and Long Term Goals?

In Business and/or in Life? Please let me know how important each goal is on a scale of 1-10 (10 = most important)

What things do you think are getting in your way/stopping you/slowing you down with these goals?

Why is it important to you to start working towards these goals now? *

What was your total household/combined net income within the last year? *

Under 25,000

25,001 - 50,000

50,000 - 75,000

75,001 - 100,000

100,001 - 250,000

250,001 - 1,000,000

Over 7 figures

Right Now... *

I have the financial resources to invest in growing my business/my life

I have access to find the resources to grow my business/life -- I can find a way

I don't have any resources and I can't find a way

If someone advised me to spend $500-2000 a month on traffic for my business for 12 months, or a course/coaching to help me reach my goals...... *

I'd know it's what any serious person needs to invest to grow their business or life, and remove obstacles to their goals

I'd feel a bit intimidated initially, but with a coach/program I like, I would do it because I'm serious about my goals and what I want

I'd avoid it at all costs because I can't figure out a way to get the capital

Phone *

City/State, or City/Country *

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