Current Progress Current Progress Current Progress Step 1 Step 2 Step 3 50% Complete Save your seat before they all fill up! Step 1 of 9 11% Name(Required) Email(Required) Phone(Required)Relationship Status(Required) Married Single Divorced Dating What is the name of your partner? (If applicable) Do you have children?(Required) Yes No What are their names and ages? Health/Vitality SatisfactionHow satisfied are you with your Vitality [Mind, Body, Emotional Wellbeing]? *(Required) Very Poor = 1 Exceptional = 10 What would make this area a 10/10?(Required) (Be as specific as possible)Mindset Review: What words or statements run through your mind when you think about NOT being where you want to be? What do you tell yourself? Intimate Relationship SatisfactionHow satisfied are you with your Relationship Health [Connection and Intimacy with your Spouse/Partner]?(Required) Very Poor = 1 Exceptional = 10 What would you like to cultivate in this area?(Required) (What would make it a 10/10?)Mindset Review: What words or statements run through your mind when you think about NOT being where you want to be? What do you tell yourself? Social Health SatisfactionHow satisfied are you with your Social Wellbeing [Relationships with Friends, Family, Colleagues, Acquaintences]?(Required) Very Poor = 1 Exceptional = 10 What would make this area a 10/10? (Be as specific as possible)(Required) (Be as specific as possible) Mindset Review: What words or statements run through your mind when you think about NOT being where you want to be? What do you tell yourself?Do you have a group of men around you to hold you accountable, and keep you disciplined and on target to where you want to go in life? Yes No Play + Joy SatisfactionHow satisfied are you with your connection to Self [Sense of Play and Joy]? *(Required) Very Poor = 1 Exceptional = 10 What would make this area a 10/10?(Required) (Be as specific as possible)Mindset Review: What words or statements run through your mind when you think about NOT being where you want to be? What do you tell yourself? Financial/Resource SatisfactionHow satisfied are you with your Finances/Resources? *(Required) Very Poor = 1 Exceptional = 10 What would make this area a 10/10? (Be as specific as possible)(Required) (Be as specific as possible) Mindset Review: What words or statements run through your mind when you think about NOT being where you want to be? What do you tell yourself?Current Annual Income?(Required) What would you like your annual income to be?(Required) Service SatisfactionHow satisfied are you with your Service/Purpose [Sense of depth, meaning, purpose in life]?(Required) Very Poor = 1 Exceptional = 10 What would make this area a 10/10?(Required) (Be as specific as possible)Mindset Review: What words or statements run through your mind when you think about NOT being where you want to be? What do you tell yourself? How satisfied are you with your Mindset [Confidence, Self-worth, Sense of Trust in Self]?(Required) Very Poor = 1 Exceptional = 10 What would make this area a 10/10? (Be as specific as possible)(Required) (Be as specific as possible)Mindset Review: What words or statements run through your mind when you think about NOT being where you want to be? What do you tell yourself? When is the best time for me to reach out?(Required) Privacy Policy: Your information will never be shared outside of this organization. x
