Application
First Name
*
Last Name
*
Email
*
Company name (if relevant)
Website (if relevant)
Social media
*
Where are you currently in your life?
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Where do you wanna be?
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What are 3 areas of your life that you want to improve?
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Tell me about one of your big audacious goals?
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What’s stopping you from making it a reality or what do you need to make it a reality?
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On a scale of 0-10 (10 being highest) how willing are you make the changes to make your dreams a reality?
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1
2
3
4
5
6
7
8
9
10
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What’s your current income bracket?
*
€0 - €99k
€100k - €249k
€250k - €599k
€600 - €999k
€1 million +
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