The Human Connection: Connection Choreography Form
Thank you for connecting with us and filling out our onboarding form. This form helps us learn more about you so that we can match you with the right Connection Choreographers and provide the best Connection Choreography(TM) to crush your goals with ease and joy.
Personal Information
Name
First Name
Last Name
Address (*somewhere you can receive packages)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Email
example@example.com
Birthday (so we can celebrate you :))
-
Month
-
Day
Year
Date
Please upload your photo (for website and other highlights)
Browse Files
Drag and drop files here
Choose a file
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Creative-living and Gig Information
Let us know more about what you love to do.
What do you love to do? Which of them would you love to generate revenue for you? (* those that you’d like or already generate income for you)
What do you do full time?
If any, what are the purpose driven work/activities you engage in? Or what topics are you passionate about?
What Role/Title (e.g., filmmaker, designer, etc) speaks to you the most
Industries/focus areas you are interested in working with
Please Select
In the Marketing industry
Women run organizations
Non profits
Corporate market
Universities
Artists
Please list roles/jobs you’re currently open to receiving along with your rates. (E.g., videographer 100/hr, therapist $150/hr, consultant…)
For gigs that THC connects you with, which percentage feels comfortable to give toward THC and sustaining the ecosystem?
5%
10%
20%
30%
Social handles or link tree
Website/Portfolio/Links to prior work
Previous media mentions
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Connection to self, earth, tech, and money
Questions checking in with your mental wellness and holistic health.
Over the last 2 weeks, how often have you been bothered by any of the following problems?
Not at all
Several days
More than half the days
Nearly everyday
Little interest or pleasure in doing things.
Feeling down, depressed, or hopeless.
Trouble falling or staying asleep, or sleeping too much.
Feeling tired or having little energy.
Poor appetite or overeating.
Feeling bad about yourself - or that you are a failure or have let yourself or your family down.
Trouble concentrating on things, such as reading the newspaper or watching television.
Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual.
Thoughts that you would be better off dead, or of hurting yourself in some way.
Over the last 2 weeks, how often have you been bothered by any of the following problems?
Not at all
Several days
Over half the days
Nearly everyday
Feeling nervous, anxious, or on edge.
Not being able to stop or control worrying.
Worrying too much about different things.
Trouble relaxing.
Being so restless that it's hard to sit still.
Becoming easily annoyed or irritable.
Feeling afraid as if something awful might happen.
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How much water are you drinking per day on average
> 16 oz
> 64 oz
> 128 oz
i grab water when i can
How would you rate your diet and nutrition?
Really don't feel good about it
Poor
Okay
Good
Great
How familiar are you with plants and herbs and their medicinal properties?
Not at all familiar
Gingerale is the closest I get
Familiar
I use a few herbal remedies
Very familiar
How would you rate your gut health?
Really don't feel good about it
Poor
Okay
Good
Great!
How would you rate your level of physical activity?
Really don't feel good about it
Poor
Okay
Good
Great
How would you rate your amount and quality of sleep?
Really don't feel good about it
Poor
Okay
Good
Great
How would you rate your ability to handle stress?
Really don't feel good about it
Poor
Okay
Good
Great
How would you rate your mental and emotional health?
Really don't feel good about it
Poor
Okay
Good
Great
How would you rate your spiritual health?
Really don't feel good about it
Poor
Okay
Good
Great
How would you rate your connections to friends and family?
Really don't feel good about it
Poor
Okay
Good
Great
How would you rate your ability to cope with fear?
Really don't feel good about it
Poor
Okay
Good
Great
How would you rate your relationship with money?
Really don't feel good about it
Poor
Okay
Good
Great
How well does your life align with your gifts, passions, and values?
Very poorly
Poorly
Okay
Well
Very well
How well does your community support you and enable you to flourish?
Very poorly
Poorly
Okay
Well
Very well
How would you rate the physical space you live in?
Really don't feel good about it
Poor
Okay
Good
Great!
How well do you incorporate healing green spaces and nature into your life?
Very poorly
Poorly
Okay
Well
Very well
How often do you incorporate technology in your ideas or execution?
Very rarely
Rarely
50/50
Sometimes
Frequently
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What's your love language?
What are the top 3 goals you’re working on right now that you want to target with your connection choreographer?
For non-new folks: what progress have you made since the last assessment? or what connection choreography have you benefitted from in the past?
We know that your personal evolution is an investment and we want to align with your monthly budget. Please check the box that best fits with your availability to invest in yourself on a monthly basis.
$0 - $50
$50 - $250
$250 - $500
$500 - $1000
$1000
Thank you so much for your time! We’re so excited to co-create with you! How was your experience filling out this form?
It was a lot
It was helpful for me
Feels empowering
Got me excited!
If we've already discussed the plan for you and/or your organization, please feel free to check out below:
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Lovers
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25.00
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Creators
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50.00
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Givers
$
100.00
Quantity
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Payment Methods
Credit Card
Apple Pay
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