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¨Decoded by Her¨ Application form

* This program is selective. Not all applicants will be accepted. *

Full name

E-mail address

Age

Why do you want to join this program?

What are you currently struggling with most in your life?

How is this problem affecting your day-to-day life or relationships?

What have you already tried to change this situation?

Why do you think this program could help you specifically?

Are you willing to commit time, effort and follow guidance for 8 weeks?

Are you ready to invest if accepted?

Is there anything else we should know about you?

How did you find me?

By submitting this application, I understand that this is not a guarantee of acceptance. If selected, I will be contacted by email with the next steps.