The Coaching Intensive filled up quickly. You can apply for the WAITING LIST for the next 8-week Coaching Intensive.

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Hello! We're excited to open this new Coaching Intensive; It's been wonderful to see so many people interested, and we apologize up front that I can't accept every person who wants or needs it.
For this reason, admission into the Coaching Intensive is limited. Admission is through a two-step process -- first the application (this form) where we determine together if your interests are matched to the program, if you have time availability and if you are able to pay the tuition. If yes to all these, I will invite you for a 30-minute Zoom call before the program starts, so I can learn more about you and you can ask questions. If for some reason I think the program will not match your needs, I'll suggest other options that I now have available.

Email *

First and last name *

City, State/Province, Country *

Tell us (in a paragraph or so) what is holding back your CPTSD healing right now, and what would help you achieve a breakthrough *

Have you participated in Crappy Childhood Fairy programs before? (Check all that apply) *

I'm a member

I've participated in Group Coaching for Members calls

I've purchased one or more courses

I've taken the free Daily Practice course

I've participated in free Daily Practice calls

I've watched videos on YouTube

I read the blog

I follow on Facebook/Instagram

Other

Required

In which areas are you hoping to heal with the support of my coaching? *

Dysregulation/Re-regulation

Isolation/Connection for people with CPTSD

Healthy dating for people with CPTSD

Healthy partnership/marriage for people with CPTSD

Work and career success for people with CPTSD

Other:

Required

Fees for the program are $1600 when led by Coaching Team, and $3000 when led by Anna Runkle. Please indicate your preference and ability to pay (If you're outside the US, please check current conversion rates to estimate the cost in your own currency). *

Yes, if I'm accepted, I can pay $3000 up front for a program led by Anna Runkle

Yes, if I'm accepted, I can pay the $1600 up front for a program led by Coaching Team

If I'm accepted, I'll request a payment plan that splits tuition into two monthly payments.

I cannot afford this program but would like to learn about other options.

Other:

Required

(If choosing group option): Please confirm you are available for Zoom meetings Saturdays from 8:00 to 9:30 am Pacific Time, from Jan 2 through Feb 20.

Yes

Most of the Saturdays (recordings will be available)

Clear selection

Please confirm: Participation in group coaching requires a commitment by each person to high standards for courtesy, mutual respect, protecting privacy (what's said in the group stays in the group), giving unsolicited advice, and refraining from discussion of politics. While it's OK to mention one' own appreciation of these things, we don't "push" any particular therapy, religion, philosophy, book or movement.

Yes, I understand and agree to this summary of terms

Clear selection

Yes, I understand and agree to this summary of terms

Clear selection

Please confirm: You understand that Anna Runkle and the Jenny Geddes are not therapists or clinicians, and that this coaching program is not a substitute for qualified professional help (psychological or medical). It is for information purposes only.

Yes, I understand that this is coaching, and does not replace professional help.

Clear selection

Please let us know any details you feel are important.

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms