Signature Program Application step 2 - Jen Mac's Something Different for Women

Jen Mac’s group & 1 on 1 programs provide excellent, secondary support to all enrolled! This means there’s support during each actual class or session via Jen's teachings, her in class or in session exercises, her homework assignments & the community you’re able to connect with here! Because we’re a community of hundreds though, it’s not physically possible for Jen to give additional private time outside of classes or sessions. Therefore, we require all participants have a primary support system already in place so you're always fully supported! This means you have any or all of the following: supportive parents(s), supportive sibling(s), supportive spouse or partner, supportive friend(s), supportive colleague(s), supportive therapist, support group, supportive clergyman/woman, supportive spiritual/religious community of some kind.(Required)

Yes, I have a primary support system in place and would like to continue.

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1. (Check off any or all that apply to you) I am a(Required)

leader

aspiring leader

doer

learner

2. At this juncture of your life, what specifically are you looking to either improve, positively change or create next for yourself, personally and/or professionally? How are you hoping my program will support you with this? Please explain.(Required)

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3. What are 3 adjectives you would use to describe yourself?

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Adjective 3(Required)

What are 3 adjectives someone who knows you really well would use to describe you?

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What are 3 adjectives you think someone who just met you would use to describe you?

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4. The following qualities identify me (please check all that apply):(Required)

5. Please share 1-3 of your greatest accomplishments to date…& why you feel they’re your greatest accomplishments so far.(Required)

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6. Which best describes you?(Required)

I’d positively contribute to any group & while my life’s presently great, I can always learn more to further develop myself... so sign me up please!

I’d positively contribute to any group & while my life’s presently good, there are definitely areas that can use improvement... so sign me up please!

My life’s presently not so great yet I know developing myself further will benefit me & that I’d still be a positive contributor to any group... so sign me up please!

My life’s presently not so great yet I need something still I’m not sure I’d positively contribute to a group right now so signing up another time’s probably best.

7. Who personally referred you to us? If you were not personally referred, how did you hear about us?(Required)

Disclaimer — Jen Mac’s Something Different for Women, LLC

I, [name], hereby declare that I am of sound mind & body while signing up for & participating in any & all classes/programs/tele-programs with Jen Mac’s Something Different For Women.

Furthermore, I understand that all of these classes/programs/tele-programs are taught to enhance my life & merely offer suggestions to me. I understand that all of these classes/programs/tele-programs & the class/program/tele-program leader do not instruct me to do anything I do not wish to do.

I also understand that the program leader for “Something Different For Women, LLC”, Jennifer Macaluso-Gilmore, does not proclaim to be a therapist, guru, PhD. or M.D. of any sort but simply an instructor, teaching philosophies & theories she has learned through her own personal education & growth. It is with the above understandings that I join in this/these class(es)/program(s)/tele-program(s). I understand that my electronic signature below constitutes a legal signature confirming that I acknowledge & agree to the above Disclaimer. My signature will be represented as follows: /First Name Last Name/.

Please type your name below (exactly as it appears above & as stated in the above paragraph, with a forward slash before your first name & a forward slash after your last name):

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