Mentoring Program Application
" Individually we are a drop. Together we are an ocean"
Leading the way toward conscious change
Welcome to the mentoring program application. I am very honored you are interested in the program and have a desire to create the life you desire. This program is for individuals who are looking for a support system and making changes from the inside out.
Whether you are at a crossroad in your life or in a place where life is everything you want it to be, having a mentor can provide guidance when additional support is needed.
"When you change the way you look at things, the things you look at change.." Dr. Wayne Dyer
Format: This is a 6 month program. We will meet once a month for 6 months
What to expect from the program:
- Deepen your awareness of self limiting beliefs and perceptions and learn tools to envision new potentials and possibilities
- A safe and supportive environment with like minded individuals
- Guidance to help empower yourself to create a culture of inspiration and shared purpose that stands as a foundation for growth and success
- Basic tools for meditation to help you decrease stress and open up new levels of creativity
- Understand habits and how to consciously choose new and supportive ones
Commitment: 6 Months.
Investment: $999 paid in full or $200 per month for 6 months
City______________ State ________________________Zip______
Home Phone: ____________________________
Cell Phone: ______________________________
Occupation: __________________________ DOB:_____________
Payment Option: Pay in Full_____ 6- $200 monthly payments______
Credit Card #_______________________ Exp_________ CRV_______
Signature: ___________________________ Date: ______________
Please submit your application to be considered for the program
Pillars of Success, LLC
7170 S Espana Way
Centennial, CO 80016
Please complete your answers on a separate page and please include your questions with the answers.
- What inspires you?
- What do you love absolutely?
- What do you consider your greatest accomplishment in life?
- Do you have any regrets?
- What would be your purpose if you knew no one would judge you? If you knew you would not fail?
- If there were no limits to what you could have or could want in your life, what would that be?
- If you had all the money in the world, what would you do?
- Who has been your greatest mentor?
- What is your intention for living your greatness?
- If you had an opportunity to share your personal message with an audience of 1000 people before leaving this life, what would that one clear message be?
- How do you want to be remembered? Why are you here?
- How do you define happiness?