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Home – Member Application Form

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All information is private + confidential. I only take on people Home can genuinely help. Please provide as much detail as possible so I can assess whether Home is the right fit for your needs + how I can assist you. Enquiries: info @ helloamygarner.com  Thank you!
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Question 1.

Your Name:

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Question 2.

Your email address

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Question 3.

Your Country of Residence / Time Zone:

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Question 4.

How did you hear about me / my work / Home?

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Question 5.

Which of the following applies to you:

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Question 6.

Which, if any, of the following issues apply to you:

This is required
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Question 7.

Which areas or what specifically do you want help with over the next 12 months?

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Question 8.

Please tell me about your situation + any A) problems and B) goals you want help with:

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Question 9.

What results and outcomes do you hope to achieve in 12 months?

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Question 10.

What challenges have blocked you getting these results so far?

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Question 11.

Why is now the right time to explore working with me?

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Question 12.

How ready + prepared are you to make a commitment to transforming these issues? (1 = not very, to 5 = extremely!)

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Question 13.

Have you read and understood the offer you are signing up for, including possible time commitment and topics covered?

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Question 14.

Have you made payment or are ready to make this investment?

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Question 15.

Anything else you would like to add:

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