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UW Group Coaching Program Application (Fall 2023)

Thank you for your interest in joining the Unconditionally Worthy Group Coaching program.

Please complete this application to share a little about yourself and why you're interested in the program. Dr. Adia will personally review your application and invite you to join her for a self-worth consultation call if the program seems like a good fit for you.

Click the button below to start.

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Question 1 of 17

Full Name

 

Question 2 of 17

Email Address

 

Question 3 of 17

Phone Number

 

Question 4 of 17

What is your racial/ethnic identity?

Question 5 of 17

What is your gender identity?

Question 6 of 17

What are your preferred pronouns?

Question 7 of 17

What is your age range?

A

20-25

B

26-29

C

30-35

D

36-45

E

Over 45

F

Prefer not to say

Question 8 of 17

What stage of your career are you in?

 

A

Early Career

B

Mid-Career

C

Late Career

D

Retired

E

Still in School

F

In Transition

Question 9 of 17

What is the biggest challenge you're having related to self-worth right now?

 

Question 10 of 17

What have you done to try to feel worthy?

 

Question 11 of 17

What personal transformation are you most hoping to experience through the Unconditionally Worthy Group Coaching Program?

 

Question 12 of 17

What are the costs of not addressing your self-worth challenges?

 

Question 13 of 17

What, if any, reservations do you have about joining the program?

 

Question 14 of 17

Have you done therapy or coaching before?

 

A

Yes

B

No

Question 15 of 17

What questions do you have about the program?

 

Question 16 of 17

How did you find out about me?

 

A

TEDx Talk

B

Attended talk or Workshop

C

Podcast

D

Instagram

E

Facebook

F

LinkedIn

G

Friend or Family Member

H

Other

Question 17 of 17

Were you referred to the program by someone? If yes, please list their name.

Confirm and Submit