ACTIVATE Strategic Wellness Investing Application Survey

Thank you for your interest in ACTIVATE

I only work with a handful of executives and leaders in ACTIVATE each year and don't extend an invitation to everyone who applies.

This application will help me determine if I can help you begin your journey toward becoming a savvy wellness investor by transforming your WELL-LEADER MINDSET™ to achieve the long-term wellness you desire and if you might be a good fit for the 12-Week ACTIVATE experience.

As such, please be thoughtful and honest when answering these questions.

1.Please enter your personal information below.(Required.)

Name

Time Zone

Country

Email Address

Phone Number

2.Briefly describe the current status of your health and wellness.(Required.)

3.How long have you been struggling with your health and wellness?(Required.)

4.What do you believe is holding you back from achieving the health and wellness you desire?(Required.)

5.What results do you believe you can achieve related to your health and wellness?(Required.)

6.ACTIVATE Wellness Advising is for ambitious, future-focused executives and leaders who are willing to step back, reflect, and think strategically about investing in their health and wellness. You must commit to making your wellness a priority, be coachable, and do the work to create an authentic Lifestyle Wellness Strategic Plan. Why do you believe you are a good fit for ACTIVATE?(Required.)

7.ACTIVATE Confirmation: Should you be chosen for ACTIVATE:(Required.)

I am ready and can commit to 3 payments of $2,300

I am ready and would prefer the $6,000 pay in full option

I am not yet ready to make my wellness a priority.