Membership Application Form

Thank you for your interest in joining the Bliss Oriented Community! It is everything you think of in the word "community" and so much more, and I look forward to the opportunity to share it with you!

This application helps us both ensure that our journey together is aligned, powerful, and impactful. Please answer the questions below with honesty and heart. Your responses are confidential and treated with respect.

Personal Information

First name

Last name

Phone

Birthday

Month

Day

Year

Location and Timezone

Waitlist if spots filled?

Yes

About You

What is calling you to apply for this membership and coaching with me at this time? (What are you seeking, longing for, or ready to shift?)

What’s your current life/business situation? (Feel free to share what's working, what’s not, and what keeps coming up for you.)

What goals or desires are you currently working toward—or wishing you could? (Clarity, confidence, success, alignment, joy, etc.)

What’s been holding you back from achieving or embodying these fully? (Any patterns, doubts, blocks, or distractions you’re aware of.)

Alignment & Energy

How would you describe your relationship with your intuition and personal truth?

What kind of support feels most nourishing and effective to you? (E.g., gentle guidance, accountability, soul-deep reflection, strategy, spiritual alignment, etc.)

Why do you feel now is the right time to commit to yourself and your transformation?

Are you ready and able to invest (time, energy, money) into your growth at this level?

Yes, I'm all in.

I'm on the fence. Would like more info.

Not sure yet.

Is there anything else you feel I should know to understand you and your vision better?

Next Steps

Once your application is reviewed, you'll be contacted to schedule a connection call to see if we feel like a good fit. This is a no-pressure space to explore resonance, alignment, and the right opportunity for your evolution.

With love & gratitude,

Andrea