Thriving After Surviving Application

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Thank you so much for you interest in Thriving After Surviving. We want to ensure that Thriving After Surviving is a safe and transformative experience for each of our participants. Please fill out the application below to be a participant in the group coaching program.

Email *

Name *

First and last name

Email *

Phone number *

What inspired you to pursue Thriving After Surviving? If you are comfortable, please provide a brief summary of your experience with narcissistic abuse. All answers will be kept confidential. *

What is your relationship status? *

Single

In a healthy relationship

In an unhealthy relationship

Other:

Participants of Thriving after Surviving will be required to show their faces on the video calls in order to maintain the integrity of the group. Are you willing to show your face during sessions? *

Yes

We want to make sure Thriving After Surviving suits your needs based on your experience. Please check the following boxes if you have experienced this aspect of narcissistic abuse:

Financial coercion

Sexual coercion

Physical abuse

Emotional abuse

Verbal abuse

Other:

The cost of Thriving after Surviving is $1,111 paid in full or $555.55 paid on the 19th of each month (2/19/22 & 3/19/22). *

I commit to paying $1,111 by or before 2/19/22

I commit to paying $555.55 per month on 2/19/22 and 3/19/22.

If you are unable to commit to either of these financial amounts, please use the box below to report your ideal budget for investing in yourself and your healing. We will work on a constructive plan that fits your budget/ your needs.

I attended the masterclass and qualify for the $888 price

Other:

Please select your preferred payment method below. *

Venmo

Cash App

PayPal

Thriving After Surviving Cohort 1 is set to take place on Tuesday, 2/22/2022. We will decide on the time based on the availability of applicants. If this start date does not work for you, please fill out the boxes anyway, as you may be a candidate for the next cohort. Someone from our Thriving after Surviving team will reach out to you regarding the waitlist and potential future start dates.

Morning

Afternoon/Midday

Evening

Nights

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Are you currently seeing a therapist? *

Yes

I have done therapy before but I am not currently undergoing therapy

We want to send a special gift to everyone who in enrolls in Thriving After Surviving. What's your address? We promise to not share this information with anyone and use it only for mailing purposes.

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