ACCOUNTABILITY • SUPPORT • CONSISTENCY

Apply for the Destination Confidence Blueprint

Complete the application below and tell me about your goals, challenges, and the level of support you're looking for.

SECTION 1: CONTACT INFORMATION

Full Name

Email

Phone

Preferred Method of Communication

Phone Call

Text Message

Email

SECTION 2: GOALS AND CHALLENGES

Tell me more about your current challenges.

SECTION 3: READINESS

On a scale of 1–10, how committed are you to making a change right now?

What specific outcome would you like to achieve over the next 90 days?

Have you worked with a coach, trainer, or accountability partner before?

Yes

No

If yes, what worked well and what did not?

SECTION 4: PROGRAM FIT

Which level of support are you interested in?

Accountability Starter ($250/month)

Accountability Plus ($400/month)

VIP Intensive ($600/month)

I'm not sure yet

Why is now the right time for you to make a change?

Why do you feel accountability would help you reach your goals?

SECTION 5: FINAL QUESTION

Is there anything else you would like me to know?

Acknowledgement. I understand that submitting this application does not guarantee acceptance into the program. Applications are reviewed to ensure the program is a good fit.

Destination Confidence

Blueprint Application

Apply for the Destination Confidence Blueprint