COURTNEY TILLIA
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Name
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First
Last
Phone Number
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Email
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What are your BIG desires for yourself?
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What are you most interested in learning more about?
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Self-care
Masculine/Feminine Energy
Manifesting
Intuition Vs. Brain
Your Purpose
Relationships
Other
What is holding you back from you showing up as the best version of yourself?
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What makes you a great fit for this experience?
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Please describe your level of commitment and readiness in investing toward yourself?
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Not ready. Not Committed.
Somewhat ready. Somewhat committed.
Not really sure- I don't know what I'm even doing here.
I'm fairly ready. I'm fairly motivated. I'm fairly committed.
I'm beyond ready, extremely committed.
What might keep you stuck from moving forward right here and right NOW?
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Please select the option that describes your readiness and willingness to show up BIGGER and BETTER than ever before.
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I have the financial capacity and I am ready NOW to invest in the support I deserve.
I don't have the financial capacity at this time, but I am hungry and ready and I'm resourceful enough to make this happen.
I don't have the financial capacity and do NOT foresee that changing.
I understand that this requires a significant commitment and investment on my part.
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Yes, I understand. I'm ready, committed, and willing.
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