Men's Sexual Mastery Training Application

First Name

Last Name

Date of Birth

Email Address

Phone

Social Media (Optional)

How did you hear about us?

Why do you feel called to this program?

What is your current relationship status?

What is the biggest challenge (or challenges) you are dealing with in your life right now?

What is your relationship to your sexuality?

Are you currently working with a therapist or a coach in any capacity?

Are you currently dealing with any type of addictions and/or addictive behavior that you are wanting to address?

Are you currently taking any prescription medications? If yes, please list

Are you aware of any traumas (sexual or otherwise) that you have experienced?

Why is NOW the time for you to step into this work?

Are you interested in 1:1 VIP Training, Group Training, or both?

Are you committed to showing up in your fullest capacity to this work?

Are you financially prepared to invest in yourself and this program?

Thanks for submitting your application. We will review it and reach out to you shortly.

Keep in touch.