Wellness x Dance Intensive 8 week Program 
(Please reserve and block off 5 minutes to fully focus and complete this application)

Complete this form and we will review your answers & reach out to schedule a call!

The purpose of this application form is to serve you at the highest level on your interview call with Serina and I to truly establish if you're a good fit for the Intensive!

Your time is valuable, as is ours, so please be honest and thorough with your answers so we can hopefully align you towards creating the best possible results with your body and dance goals that you desire.


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First Name *
Last name *
Instagram Handle @ *
Best email address
Contact Info (PHONE ) *
Thank you for that info! So picture you hop into the future 2 years from now with Anna & Serina's secret time machine. What would your dream life look like with dance & health goals? No need to be humble here. *
What level of dance do you consider yourself?  *
How all in and dedicated are you in truly achieving the results? (1 is MEH / 5 is YASS  lets go!) *
MEH
YASSSS let's go!
If not a 5 why exactly is that? Please explain.
Why haven't you been able to accomplish these results on your own yet? Detail everything that has been making it so hard for you. *
This new program is a 8 week commitment. Can you handle that? *
If you were accepted into the program would you need to talk over the financial investment with anyone else in your life before you made the decision or are you 100% in charge when making financial decisions? Please be honest. *
What have you invested so far into your health & dance goals? [previous coaches, supplements, programs?] *
Where are you with your lifestyle and priorities? *
I'm struggling to put food on the table
I'm financially stable and my main focus is making an investment to reach my fitness goals
How do you feel about investing in your health? *
Are you ready to make an investment that is may be out of your comfort zone? If not, explain why. *
What would you ideally need from us if you were accepted to work with Anna and Serina 1:1. Please be specific! *
We are very thorough with who I bring into our mentorships and want to be sure we are a great fit to work together! So last question. If you had to tell us anything that would make you more qualified to work with us over someonee else applying, what would that be? *
THANK YOU!!!
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