I am excited for you to take time to complete this form. Even if you don’t end up joining me for the 1-on-1 intensive (it’s always a heart opening adventure to clarify our desires).

By completing this application you are under no obligation to invest and schedule an intensive; we are simply opening up the inquiry and possibility that you are ready to work through the final blocks that are keeping you from your truest potential.

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After you submit this application, you’ll receive a confirmation. If you do not receive the confirmation, please contact us at support@jeannineyoder.com.

Applications are accepted at anytime and intensives are scheduled when spaces are available.

If we have open availability we will be in touch with you upon receiving your application to celebrate your acceptance. The next step will be to select the in person location (New York, Connecticut or Puerto Rico), the ½ day or Full Day and the date for your intimate day with Jey.

The Intent to Live VIP Intensive Application

Everything you share here is private and confidential. Please share openly and freely. We adore you just the way you are!

IMPORTANT NOTE: This application needs to be filled out in one sitting. You cannot save your work and come back and finish. Please take the time now to complete it or save this URL and schedule time to complete this application ASAP.

First Name

Last Name

Website

Address

City

State

Zip Code

Country

Cell Phone

Birthday

Tell Us About Yourself!

Why are you interested in life coaching?

What is the single biggest dream or goal you have for your coaching business right now?

What’s the single biggest challenge you desire support with in your personal life?

What’s the single biggest challenge you desire support with in your coaching business?

Where do you see yourself in 3 years?

Describe your top 5 desires for this year, in order of priority:

What do you see as your biggest obstacles in manifesting your desires this year?

Have you worked with a coach or mentor before? If so, what were you receiving support with, and how was that experience for you?

I work with fiercely devoted and responsible women who are a deep yes to showing up fully and honoring their word. Why do you feel I am the right coach and this is the right time for your VIP 1-on-1 session?

What experience, knowledge, resources and skills are you desiring support around specifically from me?

Why is now the most important time in your life to step out of your comfort zone and take action in investing in yourself like this?

Give an example of a time in your life when you made a commitment to take control of your life experience and find courage within yourself to step out of your comfort zone…

Please share a specific example of when you have done this and the outcome that came as a result of this choice.

I believe (and know to be true) that your intentions are powerful, should you choose to use them. A big part of the Intent to Live VIP experience revolves around getting really clear about your desires and your capability of bringing them into reality. Let’s play with this magic now:

What is your intentional outcome for your 1-on-1 consultation call with Jeannine?

Is there anything else you’d like Coach Jey to know?

Please list any questions you have for Coach Jey.

Exploration Application Acknowledgment

I’ve completed the Intent to Live VIP Application and would like to be considered for membership.
At this point in time, I understand I am only showing interest in the class and am under no obligation to commit or make payment. I understand that if it is determined that I am a good fit, I will be offered the opportunity to select a date and make payment to hold my spot.
I am committed to doing everything I need to do to get 100% from the session.

I Agree

The Intent to Live VIP Intensive Coaching is a purposeful and life changing investment in YOU and your business.

An investment in you is an investment in:

your happiness
meaning in your life
your contribution to the world
your lifestyle
the people you love
the outcome of your life experience

If this is your year to take action and say yes, I’m here to help you make it happen.

From a productivity, money and energetic perspective, we want to make sure you are making your investment confidently, and feel a deep excited yes to join Jeannine for this exclusive and high touch experience.

Please check your inbox over the next 48 hours for confirmation of your acceptance.

Sign Your Full Name

Today’s Date

Please complete this application now – it should take you less then 15 minutes.

The Intent to Live VIP Intensive Application

Everything you share here is private and confidential. Please share openly and freely. We adore you just the way you are!

Tell Us About Yourself!

The Intent to Live VIP Intensive Coaching is a purposeful and life changing investment in YOU and your business.