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6-Week Intensive: Application
This survey will help me tailor the content of our 6-week intensive to best suit our participants.
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Email
*
Your email
Full name
Your answer
Mailing address (including zip/postal code)
Your answer
Time zone
Your answer
Child's name
Your answer
Child's age
Your answer
Your occupation
Your answer
Describe the #1 issue/struggle you're currently having with your child
Your answer
What are some other issues/struggles you're experiencing with your child?
Your answer
I'm tentatively planning on holding the live calls on Thursdays at 2pm PST. Does this day/time work for you?
Yes
No
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If no, please specify 3 days and time ranges that would work for you. I realize it may not be possible to find a time that works for everyone, but I will try my best.
Your answer
What books, trainings, blogs or other resources have you used to help you parent your spirited child?
Your answer
How would you describe your current parenting style? (e.g., Attachment Parenting, quite strict/firm, very relaxed/not many rules, Authoritative, etc.)
Your answer
Do you and your partner/child's other parent struggle to get on the same page in terms of parenting style?
Your answer
To which email address should I send the PayPal invoice? A 50% deposit ($199 US) is due to reserve your spot with the balance ($200) due on or before Oct. 8.
Your answer
Send me a copy of my responses.
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