Pre-Qualification Form for Breakthrough Woman Program

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Use this to effortlessly collect wallet addresses with Wallet Connect, providing a seamless and secure connection with the most popular crypto wallets.

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Pre-Qualification Form for Breakthrough Woman Program

Please confirm you have read the Program page before applying

Name

Email

Your social media profile (Facebook/Instagram/LinkedIn profile link for identity verification)

Your current occupation

If you were to embark on your Breakthrough Journey with Valerie's 1-to-1 guidance and support for the next 6 months, what are the results you want to achieve?

What services, courses, books or programs have you tried to solve your problems? List them and describe why they didn't work for you.

Imagine your current situation never improved and worsened with time.
What would your default future look like?
What would the cost be to stay stuck?
Describe as much as you can.*

Everyone wants breakthrough and transformation. But not everyone gets to experience it because they are afraid of taking action.

Why do you think it is very important for you to take action now?
Why does it mean so much for you to breakthrough now?
Please elaborate.

On a scale of 1-10, how much do you feel you are worth investing in your breakthrough and life transformation?

When you've made this appointment, Val will honour it and make her time exclusive for you.
Once booked, nobody else can take your slot.

Please commit to the appointment by typing this sentence in the box below:
"Yes, I promise I will honour the scheduled time for my call with Valerie."

Is there anything else you’d need Valerie to know before your interview call with her? Share as you wish.

Just for fun - What is your secret dream in life?

Pre-Qualification Form for Breakthrough Woman Program

Please confirm you have read the Program page before applying

Name

Email

Your social media profile (Facebook/Instagram/LinkedIn profile link for identity verification)

Your current occupation

If you were to embark on your Breakthrough Journey with Valerie's 1-to-1 guidance and support for the next 6 months, what are the results you want to achieve?

What services, courses, books or programs have you tried to solve your problems? List them and describe why they didn't work for you.

Imagine your current situation never improved and worsened with time.What would your default future look like?What would the cost be to stay stuck?Describe as much as you can.*

Everyone wants breakthrough and transformation. But not everyone gets to experience it because they are afraid of taking action. Why do you think it is very important for you to take action now? Why does it mean so much for you to breakthrough now? Please elaborate.

On a scale of 1-10, how much do you feel you are worth investing in your breakthrough and life transformation?

When you've made this appointment, Val will honour it and make her time exclusive for you.Once booked, nobody else can take your slot.Please commit to the appointment by typing this sentence in the box below:"Yes, I promise I will honour the scheduled time for my call with Valerie."

Is there anything else you’d need Valerie to know before your interview call with her? Share as you wish.

Just for fun - What is your secret dream in life?

Imagine your current situation never improved and worsened with time.
What would your default future look like?
What would the cost be to stay stuck?
Describe as much as you can.*

Everyone wants breakthrough and transformation. But not everyone gets to experience it because they are afraid of taking action.

Why do you think it is very important for you to take action now?
Why does it mean so much for you to breakthrough now?
Please elaborate.

When you've made this appointment, Val will honour it and make her time exclusive for you.
Once booked, nobody else can take your slot.

Please commit to the appointment by typing this sentence in the box below:
"Yes, I promise I will honour the scheduled time for my call with Valerie."