Name
*
First Name
Last Name
Email
*
Phone
(###)
###
####
Date of birth
*
MM
DD
YYYY
City of residence
*
Country of residence
*
Gender
*
Female
Male
Non-binary
Genderqueer/Gender non-conforming
Prefer not to say
Preferred pronouns
*
Current occupation or primary focus
*
Marital status
*
Never married
Domestic partnership
Married
Separated
Divorced
Widowed
What are the most pressing challenges you're facing right now? List as many as needed.
*
How are these challenges impacting your life?
*
What inspired you to apply for The Purpose + Power Project?
*
What would success look like for you at the end of this program?
*
What areas of your life currently feel misaligned or are sources of stress?
*
Feel free to describe in greater detail your selections from the above list
Are there any specific outcomes you're looking to achieve through empowerment coaching?
*
On a scale of 1-10, how ready do you feel to invest time, energy, and resources into this program?
What obstacles might get in the way of you fully committing to this program?
*
Are you prepared to do work outside of our coaching calls to increase your progress?
*
How will you know this program is benefiting you?
*
What appeals to you most about The Purpose + Power Project?
*
Why do you feel now is the right time for this journey?
*
What does “empowerment” mean to you personally?
*
If you had a magic wand that granted you your ideal life 1 year from now, what would it look like? Describe in as much detail as possible.
*
Have you worked with a coach, counselor, or therapist before? If so, what kind? How was this helpful or unhelpful in your journey so far?
*
Do you have any concerns or hesitations about joining this program?
*
If selected, would you prefer weekly or bi-weekly sessions
*
Weekly
Bi-weekly
Not sure
What would be your preferred payment plan?
*
Full payment upfront
3 month installments
6 month installments
Not sure yet
How did you find Carol/The Purpose + Power Project?
*
Is there anything else you would like to share with me?
*
DISCLAIMER & DECLARATIONS
*
By submitting this form, you acknowledge and agree to the following:
1. Eligibility: This program is intended for individuals who are mentally stable and prepared for personal development work. It is not suitable for those in acute emotional distress or crisis.
2. Not a Replacement for Therapy: The Purpose + Power Project is a coaching program and not a substitute for therapy, counseling, or professional medical services. If such services are needed, please seek support from a licensed professional.
3. Responsibility for Outcomes: The program provides tools, guidance, and support, but results depend on your active participation and commitment. You release Caroline Xavier from any liability for outcomes, understanding that transformation requires your full engagement.
4. Refunds and Cancellations: Payments are non-refundable once the program begins. Cancellations require sufficient notice, and rescheduling options will be offered when possible.
5. Application Process: Completing this application does not guarantee acceptance. If aligned, you will be invited to a complimentary consultation to confirm fit.
6. Confidentiality: All information shared in this application and coaching sessions will remain confidential and used solely for program purposes.
7. Results May Vary: This program supports personal growth and transformation, but individual outcomes depend on your readiness, participation, and unique circumstances.
Thank You for Your Application!
Your interest in the Purpose + Power Project is a powerful first step toward the transformation you’re seeking. I’m honored that you’ve chosen to explore this journey with me.
Your application has been received and will be reviewed carefully to ensure alignment with the program’s focus and goals. If your application is a good fit, I’ll be in touch within 3-5 business days to schedule your complimentary consultation.
During the consultation, we’ll:
- Explore your goals and current challenges.
- Discuss how this program can best support you.
- Answer any questions you may have about the process.
In the meantime, if you have any urgent questions, feel free to reach out to me using this form.
I look forward to connecting with you soon and supporting you on this exciting journey!
Warmly,Carol Xavier
