BecomingHer Application

First name

Last name

Phone

Address

What is your current profession or career role?

How would you describe your current health and wellness journey?

Have you tried fitness, diet, or wellness programs before? What was your experience?

What are your top 3 goals over the next 12 months?

On a scale of 1–10, how ready are you to invest in your transformation?

What do you believe has held you back from reaching your goals?

Why do you feel now is the right time to commit to this journey?

Are you ready to prioritize your transformation?

Yes, I’m ready now

I’m curious but want to learn more

I’m not sure this is the right time

This is a premium-level program ($497/month or $1400 if you pay in full). Are you financially prepared to invest if accepted?

Yes, I’m ready to invest

I may need a payment plan

No, not at this time

Anything else you'd like to share about your journey or why you’d be a great fit?