Name*Email* Contact Phone Number*What interests you about this program and what do you hope to gain from this program*What are the 3 major blocks that you are experiencing?*This program will have 3 live sessions 2 hour each. In order for you to get the most, you need to attend all 3 sessions. Are you able to commit to attending all 3 sessions?*YesNoCheck all the days/times you are open for this class. Tentative time blocks are 7-9p or 12-2p. We can choose multiple times during the week.* Select All Monday 12-2p Monday 7-9p Tuesday 12-2p Tuesday 7-9p Wednesday 12-2p Wednesday 7-9p Thursday 12-2p Thursday 7-9p Friday 12-2p only EmailThis field is for validation purposes and should be left unchanged.