Application to Explorer's Club

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* 1. Why does The Explorer's Club sounds interesting to you?

I'm ready for a year of more learning, self-study, reading, and travel

I feel great and want to feel even greater

I am feeling stuck and ready to put energy and investment in growth

I am lacking inspiration and purpose

Honestly, I'm struggling and want to get out of the rut

Other (please specify)

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* 2. On a scale of 1-10, how would you rate your satisfaction with life? 1 is unhappy, and 10 is absolute joy.

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* 3. Please take a minute to share the most difficult part of your journey at this moment in time. (work, relationship, time)

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* 4. What holds you back in life?

Self-doubt

Never enough time

Too many regrets

Lacking purpose

Loneliness

Other (please specify)

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* 5. If the next 12 months of your life turned out to exceed your wildest expectations, what would that look like?

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* 6. Being that we are talking about a year of exploration, what would you like to share about yourself? (passion, profession, favorite band, etc)

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* 7. Please click here to set up a time and let's talk one on one to learn more about The Explorer's Club

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* 8. Can you please share you contact info

Name

City/Town

State/Province

Email Address

Phone Number