Alcohol-Free(dom) Group Coaching w/ Amanda Kuda - Application
Please fill out the below form to apply to join Alcohol-Free(dom) Group Coaching. All applications will be reviewed immediately and we'll let you know if your application has been accepted within 24-hours. The application process for our Summer, 2019 session closes at midnight on July 22.

If you are applying to the program before the registration cart opens, you'll also get first access to discounted prices and extras by applying early.
Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Were you sent a coupon code? Share the code in the link below so that we can extend any discounts to you.
Your Time Zone (to help determine the best time for group calls - right now, they are scheduled from 7-8:30 CST, but can be flexible based on the composition of the group) *
Age
Alcohol-Free(dom) is a program designed for "gray area" or "social" drinkers and is not intended for women who are addicted to alcohol or are in active recovery. *
Required
What is Your Current Relationship With Alcohol *
How many days of the week do you/did you drink on average? (If you're alcohol-free, share how often you were drinking before) *
How many drinks do you/did you consume in a typical setting? *
How, if at all, do you feel alcohol is holding you back in life?
If you've tried to moderate or take a break before, what did you try and how did it go? *
What have you found difficult about changing your relationship with alcohol? *
Why are you serious about changing your drinking now? *
Why are you interested in group coaching as a solution to your drinking? *
In addition to not drinking, what would success look like for you 3 months from now? *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Amanda Kuda International. Report Abuse
Google Forms