The Radiance Refinery - Application

*Please read before starting the application.* This application is designed to help me determine if you will be a good fit for the Radiance Refinery wellness program. Only fill this out if you are READY to commit to 12 weeks of making life changing break-throughs and transforming your body, mind, style. I am looking for women who are action-takers and are ready to hit the ground running! So, if you're ready to get with the program, do the work, and get the body you've always wanted, I'd love to hear from you! Are you ready?

First name

Last name

Instagram Handle

What are the top 2-3 goals you'd like to achieve in the next 6-12 months?

What have you tried in the past to reach those goals?

Why are those goals important to you? What's motivating you to make them happen NOW?

I only work with a select number of people at any given time. Why do you feel that we will be a good fit to work together?

I'm ready to give YOU all of the tools and keys to acquiring long-term wellness, but I only work with women who are highly coach able and ready to do the work. Can I count on you to be an action-taker?

Yes

If we both decide it's a 'YES' to work together, the investment options start at $250 per month. Are you prepared to make that investment if it means reaching all of the goals you've shared?

Yes, I'll even pay in full for a $100 discount!

Yes, but I'll need a payment plan

No, my goals will have to wait

I want to subscribe to the Radiance Refinery + DWR mailing list.