Full Name
*
Email
*
Phone
*
Date of Birth
*
What country do you stay?
*
Tell me why you need my help.
(Describe In detail) How long have you been feeling this way? What have you tried in the past to help you? How much time and money have you spent trying to achieve this?
(Describe in detail) How much do you want to live a life filled with positive choices? How will things be different if you achieved this? What’s at stake if you fail?
Do you have any of these feelings? Please tick box which resonate with you
Anxiety
Depression
Suicidal thoughts
Sadness
Guilt
Shame
Not belonging in the world
Fear
Confusion
You do not know what you are feeling
Are you connected to your spiritual team, if so, how often?
Why do you feel you deserve a £2.5k scholarship with Ann?
Submit