Name
(Required)
First
Last
Email
(Required)
Zip Code
(Required)
Do you read self-help books/ listen to any such material? If yes! Please describe briefly
Have you seen a therapist in the past year?
(Required)
Yes
No
Not in the last 1 year, but I have seen a therapist in the past
Are you married?
(Required)
Yes
No
Are you divorced?
(Required)
Yes
No
What is your highest priority in life at this moment?
(Required)
What do you hope to get out of being part of this community?
(Required)
Statement of Integrity
(Required)
I attest that I only wish to seek the community of men to work on myself and discover my purpose and passion in life.
I am not here to explore any business opportunities or promote my business in any way.
I understand and agree to the Statement of Integrity.
Application Fee
(Required)
Price:
After you pay the application fee, you’ll be taken to our scheduling page to book your intake consultation interview.
Credit Card
(Required)
Pay the application fee and schedule your intake consultation interview.
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