Premium Service Application Form
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Email *
FIRST + LAST NAME *
DATE OF BIRTH *
WHAT IS YOUR MAIN INTEND FOR REACHING OUT TO US? *
WE SPECIALISE IN SPIRITUAL & SEXUAL TRANSFORMATION TO SUPPORT YOU IN CREATING MORE PLEASURE IN LIFE, MORE PASSION IN THE BEDROOM AND MORE PURPOSE IN THE BOARDROOM. THIS INCLUDES GAINING A DEEPER UNDERSTANDING OF YOUR UNIQUE SOUL MISSION + HOW TO TRANSLATE THAT INTO YOUR LIFE, RELATIONSHIP(S) AND BUSINESS WITHIN THE NEXT 365 DAYS. IS THIS SOMETHING YOU WISH TO LEARN MORE ABOUT? *
WHERE ARE YOU CURRENTLY AT WHEN IT COMES TO YOUR LIFE (PURPOSE), LOVE (RELATIONSHIP) AND LEADERSHIP (IN BUSINESS)? DESCRIBE IN DETAIL WHAT YOU APPRECIATE AND WHAT YOU WOULD LIKE TO IMPROVE AND WHY. *
WHEN WORKING WITH US, WHAT DO YOU EXPECT TO LEARN? *
WHEN WORKING WITH US, HOW WOULD YOU LIKE TO FEEL? *
ARE YOU WILLING TO INVEST A MINIMUM OF 4 OR 5 FIGURES A MONTH TO GAIN CLARITY ON YOUR SOUL MISSION AND CREATE MORE PLEASURE IN LIFE, MORE PASSION IN THE BEDROOM AND MORE PURPOSE IN THE BOARDROOM? *
WHICH PREMIUM SERVICE ARE YOU INQUIRING ABOUT? *
Are you interested in receiving Nicole's Newsletter and personal blog on love, romance, intimacy and sex? (You can subscribe any time.) *
When you have completed this form, please send us private message and we will have a look at what we can do for you moving forward. *
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