JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Mayara Healing Art's One-On-One Program Application
Thank you for your interest in working with me!
Please fill out this form so I can learn more about you.
I'll email you back asap, and if we are a good fit to work together I'll give you a link to book a discovery call with me so we can talk about more details.
Leave your best email address below so I can contact you.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
What's your full name?
*
Your answer
What is your date of birth?
*
MM
/
DD
/
YYYY
What is your phone number?
*
Your answer
What are your social media handles (if you have any)?
*
Your answer
What are your biggest struggles right now?
*
Your answer
What are your biggest goals and dreams?
*
Your answer
What have you currently been doing to reach those goals?
*
Your answer
Why do you feel called to work with me privately, and how do you think working with me can help you reach these goals?
*
Your answer
My one-on-one program packages go from $1,999 USD to $4,444 USD with payment plan options. - If you knew that this program would give you everything you need to reach your goals, would you be able and willing to invest this amount or more?
*
Yes, definitely.
I'm not in the financial position to invest in something like this now.
Yes, but I would need a payment plan.
What is your level of commitment in working with me?
*
Just curious
I would like to know more
I'm in, but have a few questions
I'm 100% committed!
Do you have any hesitations about hiring me as a coach?
*
Your answer
Why now is the perfect time for you to own your desires and make them reality?
*
Your answer
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms