DharmaBridge Application

DharmaBridge or CCLI Inquiry

Meditation, Dharma and Visionary Leadership Coaching with Kelly Blaser
We are currently accepting applications for the DharmaBridge cohort beginning in February 2024!

Please provide robust answers to the questions below. Applications with sparse answers will not be accepted.

If answers to some questions don't come easily, we invite you to leave them until the end, and then have another look to see if anything new comes up.

There is no right or wrong answer! "First thought best thought." - Alan Ginsberg

OK - dive in!
Full Name*

First NameLast Name
E-mail*
Phone Number*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Occupation
Which Program are you most interested in?

DharmaBridge LotusDharmaBridge CCLI (for Coaches, Counselors, Leaders and Innovators)Not sureOther
Briefly, what’s working well for you right now in your life?
What’s a challenge for you right now?
What are your dreams, goals, or hopes? What is your vision for your life?
What do you believe prevents you from having the life you want?
Are you prepared to consider a significant life change and investment of time/resources?

YESI feel the possibility, but have some considerations.I am not ready for a significant change and investment at this time, but want to feel it out for the future.Other
Anything left unsaid?
Thank you for completing this form. After you click Submit, please schedule an exploratory consultation with me on the next page. I look forward to connecting with you and learning more about your journey.

Love,
Kelly
Should be Empty:

DharmaBridge or CCLI Inquiry