Blocked 2 Blissed Group Coaching Application

This is an application to be considered for the next 8-week session of Blocked 2 Blissed Group Coaching Program, led by Rebekah Borucki and opening on July 1, 2019.

Thank you for your interest in this program and for answering your survey answers with complete honesty.


▻ Completed application
▻ $597 participation fee upon acceptance to program (a 3-part installment plan is available and details will be sent to you with your acceptance email)


➤ 8 week / 12 module group program

➤ Unlimited lifetime access to the exclusive Handel Method InnerU™ online course curriculum ($650 value)

➤ 6 weekly group calls, hosted live on video and led by me (the first call is scheduled for July 14)

➤ Our private program Facebook group

➤ An accountability partner (your Bliss Buddy™
) to work with during the program
➤ Hot seat one-on-one coaching opportunities on every call (everyone is guaranteed at least one hot seat over the course of the program)
➤ Lifetime access to all future rounds


▻ This course will move fast and might feel intense at times. You must be ready to create space for this work in your life.
▻ You will be called to do hard work, to be challenged, and to challenge others. Collaboration is key in this process.
▻ Your participation is crucial to your success as well as the success of the tribe. Failure to complete homework or attend live calls on a regular basis could result in expulsion without refund.
▻ The work we will be doing in this group is sacred work. Sharing program content or other people's personal stories outside of the group is strictly forbidden. Any violation of this will result in immediate expulsion without refund.

If that all sounds good to you, let's get you started on the application!

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* 1. Full Name

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* 2. Location & Time Zone

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* 3. Email Adress

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* 4. Why are you interested in this group coaching program? What’s not working for you now? Why haven’t you been able to make the desired changes or reach your goals on your own?

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* 5. Which coaching programs or self-help systems/books have you used in the past? Rate each one on a scale of 1 to 10 (10 being completely perfect) for the positive effect it had on YOUR life (a program can be awesome or terrible for another person, but that doesn’t mean you have to have the same experience).

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* 6. What outcome would you like to see after working together for 12 weeks?

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* 7. What is your communication style? What kind of leadership style to you respond to best? How receptive are you to constructive, but firm, criticism?

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* 8. How good are you at follow-through? Do you tend to quit things early, or is commitment and completing tasks easy for you? How committed are you to doing this work with the group?

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* 9. Do you understand and agree that repeated lack of participation (not showing up to meetings or watching replays, not turning in homework on time, not showing up for your Bliss Buddy, or breaking confidentiality) could result in expulsion from the program without refund? Your presence is so valuable to us!

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* 10. How did you find out about the program (please list a name if you were referred by a friend).