Last Love Blueprint Call Application

1
Name* This field is required.
First Name
Last Name
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Are you at least 21 years of age, female, AND 100% ***SINGLE?**** This field is required.***SINGLE means that you are NOT married, engaged, living with someone, OR in a committed, exclusive relationship -- even if you are currently fighting with your partner! Please be honest about this! If we get on a call and you tell me you're in a relationship, I will end the call and you will not be permitted to schedule another one later.
YESNO
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How did you arrive at this application?* This field is required.
from webinar
email
social media post
messenger/other
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Do you have a US-based mobile phone?* This field is required.
YESNO
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Please enter your MOBILE (Cell) Phone Number Here.* This field is required.
Please enter a valid phone number.
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Please provide your facebook profile link here, so I can contact you via Facebook messenger (copy and paste the link in your browser when you are on your own profile page.) ***PLEASE NOTE: This is an absolute must if you do not have a US-based mobile phone for me to contact you. * This field is required.
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Email* This field is required.
example@example.com
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Tell me a little about yourself, so we can get to know each other better.* This field is required.(i.e., your age, what kind of work do you do... do you have kids, what are your hobbies, passions, goals/dreams... whatever you feel comfortable sharing)
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There are a lot of love coaches out there... Why are you applying to talk with me, specifically?* This field is required.
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How long have you been single?* This field is required.
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Tell me a little about your love history.* This field is required.(i.e., what kinds of issues / failures / successes have you had in dating and relationships, what kinds of men do you usually attract / choose)
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What is the most frustrating part for you of NOT having the loving relationship you want in your life?* This field is required.
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Please describe what you are looking for in a partner and relationship.* This field is required.
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What have you already tried to find love? (select all that apply)* This field is required.
Online dating
Matchmaker
Dating coach
Meeting men the "old fashioned" way (out at bars, through friends, at church, etc.)
Law of Attraction/Manifesting
Not much. Just hoping it will happen when I'm not looking.
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Why do you think it is that you haven't yet manifested the relationship you want?* This field is required.
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At this point in your life, how important is it to you to find love?* This field is required.
There is nothing more important to me. I am happy and satisfied in other areas of my life. This is the one thing that's missing, and I want someone to share it all with.
It's important, but I'm not sure if it's important enough to risk getting hurt.
If it happens, great. If not, that's fine too.
I have more important things to worry about. It's not that important.
I want it very much. I'd say it's at the top of my priority list right now.
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Do you consider yourself open-minded, coachable, and willing to learn and grow? (i.e., are you ready to make changes in your beliefs and behaviors in order to get different results in your love life?)* This field is required.
Yes
No
Not Sure
18
Do you believe that I can help you learn how to transform your vibration to attract and manifest your soulmate?* This field is required.
Yes
No
Not sure yet
19
Are you open to the use of energy work, meditation, hypnosis, and law of attraction (manifesting) to achieve your goals in your love life?* This field is required.
Yes
No
20
Do you have time (or can you make time) in your life to put in the effort to get what you really want in terms of love?* This field is required.
Yes
No
Not Sure
21
Other than love, in what areas of your life are you currently struggling?* This field is required.Please select one or more.
health
finances
family issues
other
nothing else but love
22
After the free call, if you love what you hear, would you be able and willing to invest financially in a program that can get you the result you are seeking -- namely, the love of your life?* This field is required.
Yes, if I really believe in the program and the coach.
No. Even if I believe I can get the results I want, I'm not financially able (or willing) to invest.
23
What is your current professional/employment status?* This field is required.
Full time employed ( professional / managerial )
Full time employed ( sales / corporate )
Full time employed ( skilled trades )
Full time employed ( laborer / retail )
Full time employed ( other )
Part time employed
Unemployed / Disability
Self-employed
Financially Independent
Retired
24
Are you able to set aside approximately 90 minutes of quiet, uninterrupted time to get the most out of this call?* This field is required.
YESNO
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Is there anything else you would like to add to your application to further explain why you want to book this call?
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