Self-Mastery & Empowerment Program Application

I'm so glad you are interested in this important personal work. Please answer a few questions so I can get to know you and your goals for this program better. 

Click the button below to start.


Question 1 of 13

First and Last Name

Question 2 of 13


Question 3 of 13

Phone Number
Please provide the best number to reach you.
If you are outside the US, please include your country code.

Question 4 of 13

Current Location. 
(not your address, just where in the world you are currently spending the majority of your time)

Question 5 of 13

Which level of the Self-Mastery and Empowerment Program are you interested in? 


The Solo Experience - I just need to be pointed in the right direction and handed a map.


The Ultimate Individual Support for Total Life Transformation - I really need personal guidance throughout this journey.


The Mastery Program - I'm an entrepreneur, business owner, coach, or therapist and want to take my personal and professional life to the next level.

Question 6 of 13

Please tell me about your life now and why you are motivated to do this personal work. 

Question 7 of 13

What are the biggest challenges in your life and/or business that you feel are keeping you stuck? 

Question 8 of 13

Dream into the future. What improvements would you like to see in 6 months? 

Question 9 of 13

Are you currently doing any other personal development work? Please describe this work and it's impact on your life. 

Question 10 of 13

Are you currently Meditating or doing another form of Spiritual practice? 
If so please describe how long and the impact on your life. 
If not are you willing to do a daily practice for the duration of this program? 

Question 11 of 13

I have read the program description thoroughly and I am ready to commit the time and energy necessary to complete this program. 


Yes! I'm ready, when do we start?!


Yes.... but I have a hesitation about something.

Question 12 of 13

If you are interested in doing this program but have any hesitations or concerns please share what they are so I can determine what kinds of support you may need.
Example: "I have a chronic medical condition and I'm worried about the time commitment" 

Question 13 of 13

Do you have any questions? Is there anything else you would like me to know about you? 

Confirm and Submit