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1. Do you struggle getting through the holidays? (Required.)

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2. Do you think you can change this struggling?

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3. Would you like to stop struggling and tell a different story?

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4. What's are your major areas of struggle? (Check as many as apply)

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5. Which is the PRIMARY area you'd like to work on?

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6. Which solution would you be interested in?

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7. If interested in a WEEKLY CLASS, leave your name & email address so I can contact you with details (your info will be added to an autoresponder list to enable mass mailing)

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8. If interested in INDIVIDUAL COACHING, leave your name & email address so I can contact you with details (your info will be added to an autoresponder list to enable mass mailing)

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9. Please leave any other comments you would like me to see.

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