6 Weeks Coaching Intensive — Grit & Gratitude

The Dom Peri-Slay Application

You are applying for the 4 weeks 1:1 Voxer all access coaching experience. Please fill out the form and wait 2 Business Days (Monday-Thursday) for a response.

Name

First Name

Last Name

Age

Time Zone

Tell me about yourself. What do you do for a living? What are you passionate about?

Why do you want to do this 4 weeks all access coaching with Jerakah?

What do you want to accomplish while we work together?

Jerakah uses The Grit & Gratitude Method as the foundation of her coaching. Which 2 areas do you need the most support with?

Start each day with Gratitude

Look to the future through Manifestation

Take intentional Action by Prioritizing your goals

Remember Why you started

Which payment plan best fits your needs?

If payment plan is approved, a contract will be sent with payment dates & terms

Any questions or concerns?

The Dom Peri-Slay Application

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