Welcome, you Brilliant Woman.

Enrollment for: January 18th

Welcome to the 12-week Journey.

Fill out the form below in order to join the program. Hello you brilliant woman.

This is a fun form so we can get to know you on a deeper level. It will take about 10-15 minutes.
You will be redirected to the payment page when you finish.

First and Last Name*
Email address*
Enter Email Confirm Email
Phone number (with international code like +61...)*
Date of birth*
Full Postal Address*
We will be sending you a little welcome gift 🙂
Tell us about your main intention in joining this program.
Tick the boxes that best describe your status:
- I am employed part or full time
- I am a freelancer / entrepreneur / contractor
- I am a student
To better understand your emotions, body, and hormones, tick the ones that apply to you:
- I am taking birth control pills
- I have a IUD (intrauterine device)
- I've had children
- I am currently in a serious relationship
- I have or have had diagnosed anxiety or depression
- I have had body image disorders (such as anorexia, bulimia)
Life is a ride. Describe any inner work you might have done before or are currently doing such as therapy, coaching, spiritual practices, meditation etc. (Write 'none' if this is your first time)*
Tell us about some of your hobbies or passions.
What’s your favorite thing about yourself?*
What’s your biggest challenge at the moment?*
Birefly, what do you do or what is your general professional background? (Even if it might be changing)*
What are you the most excited about in joining this program?*
Think about one of your favorite 'feel good' song. Paste the Spotify or YouTube link of it here.*
All done sweet thing! Is there anything else you want to tell us?*
Comments
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Welcome, you Brilliant Woman.

Enrollment for: January 18th

Welcome to the 12-week Journey.

You are brave.

A 12-week journey to reconnect with your power.

Practical, Actionable Wisdom

A Community of Brave Women

Inspirational, Trained Women guiding You

Commitment and Accountability