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IMMERSE Inner Circle Speaker Application
Name
*
First
Last
Email Address
*
Are you a current member of the IMMERSE Inner Circle?
*
Are you a current member of the IMMERSE Inner Circle?
Yes
No
What Coaching Plan are you subscribed to?
*
What Coaching Plan are you subscribed to?
SuperWoman
SwiftWoman
StretchWoman
What's your Growth Pathway?
*
What's your Growth Pathway?
Cleanse
Clarify
Create
Contribute
Catalyze
Select your Coaching/ Speaking / Mentoring Experience
*
Select your Coaching/ Speaking / Mentoring Experience
Aspiring (interested to share knowledge)
Evolving (less than 3 years)
Established (3 - 7 years)
Mastery (Over 7 years)
Select Category you'd like to speak on:
*
Select Category you'd like to speak on:
Emotional Wholeness / Healing
Life Clarity, Self-Discovery / Identity
Goal Setting / Vision / Intentional Life Design
Execution/ Fulfilling Purpose/ Growth
Leadership Success / Multi-Influential Life
Other Specialized Topics (select below)
If you chose Other Specialized Topic, please specify below:
*
If you chose Other Specialized Topic, please specify below:
Spirituality
Fitness and Health
Relationship and Marriage
Parenting and Family Life
Money/ Finances
Business / Career
Personal Achievement
Civic Responsibility
What would you like to speak on? (Optional)
How would you prefer your Speaking Slot to go?
*
How would you prefer your Speaking Slot to go?
A Private Recording
An Interview Session, moderated by u
Other
Specify Other
*
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Live Awake Conference 2020
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