Application Part Two | Liberating Lives

Liberating Lives Client Application (Part 2 of 2)

Please complete the form below and click the "Submit" button to complete the application process. We will respond within 24 hours. We look forward to working with you!

Full Name

1. Please write a brief life story, giving whatever background you wish. and 2. What do you value?

3. Why do you want to be accepted into the Liberating Lives Residential Academy? and 4. What specific issues would you like to work on?

5. Have you ever attended a residential program before? If yes, describe your experience. and 6. Are you now or have you ever been in counseling or therapy? If yes, please explain.

7. Briefly describe your spiritual journey. and 8. In what ways do you sense God might be challenging you, nudging you, or trying to get your attention?

What are some of your insecurities about being coached/mentored/trained?

9. What are the major things happening in your life right now? and 10. How would you like your life to be different one year from now?

11. How would you like your life to be different one year from now? and 12. What is getting in the way of making changes or accomplishing personal goals? and

13. List three things you’re procrastinating on in your life right now. a. b. c.

14. If you are accepted, in what ways might you undermine or sabotage the process? and 15. How do you think we could help you stop doing this?

16. What are some of your insecurities about being coached/mentored/trained?

Congratulation! You have successfully completed the application. We will contact you within 24 hours to schedule an interview to complete the application process.

Liberating Lives, Inc.

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Supporting Formerly Incarcerated Women to Reduce Recidivism

Liberating Lives Client Application (Part 2 of 2)

Please complete the form below and click the "Submit" button to complete the application process. We will respond within 24 hours. We look forward to working with you!