Break The Cycle Interest Form

Please fill out the form below with as much honesty and authenticity as possible. This is not an interview - but to gauge if BTC and the BTC community is a right fit for you and your needs! There is no right or wrong answer, and any and all details are welcome and appreciated for me to get a sense of you and how I can support. Once you're done with this form, you'll hear back within 2 business days with next steps!

All information about Break The Cycle Foundations is here: https://bit.ly/BTCfound 
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Email *
First and Last Name
Location (city, state/country and time zone)
Pronouns
Break The Cycle Foundations is open to BIPOC (Black / Brown / Indigenous / People of Color. Do you identify as such?Please feel free to share details (East Asian, Korean American, bi-racial, 1st generation, etc) *
How did you find out about Break The Cycle? *
What brings you to apply for the cohort of Break The Cycle Foundations? Please share all the things you feel called to/what you feel is important to know about you *
What are the biggest challenges in your business and life currently? *
Have you participated in other personal development or training programs? What other forms of support do you currently participate in/with for mental, physical, spiritual, emotional support? Please list any/all from the last year. ex: therapy, coach, regular calls with friends, meditation, breathwork, yoga, etc. *
Please share any information about your physical or mental health history that is relevant to the healing work we will be doing.
What day out of Tuesday, Thursday, or Saturday are you available/prefer to join the live coaching calls? Please indicate if mornings or afternoons are preferred *
Please select the response that most describes how ready you are to join the magical and healing community that is BTC. It is a 6 month journey that is hybrid between self paced content + breathwork+ embodied live coaching calls. *
If you responded with the 2nd or 3rd option, please share your questions, fears, or concerns here! All of these are received with a ton of love and please know that if it's not a fit I will be able to recommend other coaches/practitioners. I'd love to support you in making the decision that is best for YOU.
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