RISE is a sacred, 6-month journey for women ready to move from survival into sovereignty. Because this work unfolds in deep, personal layers, we welcome only a small circle of participants in each cohort.

This application is an opportunity for reflection — to help us ensure the timing, support, and investment level is aligned for your journey.

About You:

Street Address

City

State

Country

Postal code

Your Readiness

Where do you feel you are in your healing journey? *

Navigating immediate crisis or an unstable environment

Stabilized and beginning to explore deeper healing

Ready to soften, release, and expand

If you closed your eyes and felt into this decision… what part of you is saying yes? What does she need to feel safe stepping forward? *

What stirred your heart to apply for RISE at this time? *

Have you experienced coaching, therapy, or other healing spaces before? (Yes/No – if yes, feel free to share briefly) *

Support & Safety

RISE is a somatic, body-based healing program created for survivors who are safe, stable, and ready for deeper work.

If you are in active crisis, unsafe in your living environment, or not yet comfortable exploring body-based practices, this may not be the right time for RISE.

Your honesty helps ensure this program is safe and supportive for you.

Are you currently working with a therapist, counselor, or other support professional? (This is not required, but can be an important resource alongside this work.) *

YES

NO

Do you currently have at least one source of support? (friend, therapist, healing circle, etc.) *

YES

NO

Are you currently in a safe living environment, free from ongoing abuse or violence? *

YES

NO

Are you currently in crisis (e.g., experiencing active suicidal thoughts, self-harm, or ongoing domestic violence)? *

YES

NO

This program includes gentle, body-based practices such as breathwork, grounding, and nervous system awareness. Do you feel comfortable exploring these types of practices at this time? *

YES

NO

Have you ever been diagnosed with a mental health condition that might make this program difficult or unsafe for you right now (such as untreated schizophrenia, bipolar disorder in active mania, or severe dissociative identity disorder)? *

YES

NO

Is there anything else you’d like me to know about your healing journey, your goals, or what you hope to receive from this program?

Investment Alignment

Please choose the tuition tier you can confidently commit to. A limited number of scholarship spaces are reserved for those experiencing significant financial hardship.

Which investment level best reflects both your current financial reality and your desire to say yes to this path? *

Full Tuition — $2,400 (most spaces held here- 75%)

Partial Tuition — $1,200 (limited spaces- 15%)

Deep Scholarship — $600 (limited spaces -10%)

Full Scholarship — $300 (limited spaces - 5%)

I am requesting a 6 month payment plan for chosen tier

If requesting a scholarship, you’re welcome to briefly share your current financial reality. (optional but helpful)

Early Enrollment Bonus

If enrolling under the Full Tuition Tier and within 2 months of the portal opening, which Pre-Path Bonus would you like to receive?

UNBOUND: 30 DAY TRAUMA BOND DETOX

THE SHIELD: THE SACRED ART OF PROTECTING PEACE

Sacred Agreements

If invited into the RISE circle, are you ready to commit to this 6-month journey of devotion — for yourself and in community? *

YES

NO

I understand RISE is a trauma-informed program and not a substitute for therapy. I remain the sovereign steward of my wellbeing. *

YES

Any Additional Comments or Questions?

Want to share your heart in another way? You’re welcome to upload a short audio or video message instead of (or in addition to) your written answers.

Signature *

Clear

Date *

I Consent to Receive SMS Notifications, Alerts & Occasional Marketing Communication from company. Message frequency varies. Message & data rates may apply. Email [email protected] for assistance. You may unsubscribe at any time.

I’d like to receive occasional soul notes, journal prompts, and updates about future offerings — even if now isn’t the right time.

Your words will be received with care.

Thank you for inviting me into your journey.