Alignment Ascension Application - Karen Kleinwort

🌸 About You

Name *

First

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Website / URL

Location / Time Zone

e.g. Michigan EST

Preferred Pronouns

e.g. he / him / she / her / they / them

Name of Business

🌿 Where You Are Now

Tell me a little about your business or current professional focus.

What inspired you to explore private coaching at this point in your journey?

What feels most “out of alignment” in your business or life right now?

How do you currently make decisions in your business?

Intuition and gut feeling
Data and logic
A mix of both
I’m still learning to trust my process

What would you most love to create or experience over the next 6 months?

🌕 The Journey Ahead

Which aspects of this holistic approach feel most resonant to you? (Check all that apply)

Energy work (Reiki, alignment sessions)
Strategic business coaching
Mindset and leadership development
Body-based integration (CranioSacral Therapy)
Spiritual exploration (past life regression, intuition work)

What kind of support helps you thrive most? (Check all that apply) (copy)

Gentle accountability and structure
Spiritual or intuitive reflection
Direct strategy and action steps
Collaborative discussion and creative brainstorming

What challenges have you encountered in previous coaching or personal growth experiences (if any)?

On a scale of 1–10, how ready do you feel to invest your time, energy, and resources in your next level of growth?

Selected Value: 1

Pronouns do business

💫 Program Preferences & Logistics

Which program length are you most interested in?

6-Month Alignment Ascension™
12-Month Deep Expansion Journey
4-Week Intensive

How do you prefer to connect for your sessions?

Zoom (virtual)
In-person (Mid-Michigan)
Hybrid (mix of both)

Would you like to be considered for enrollment this month or at a future date?

This month
Within 3 months
Within 6 months

🌸 Closing Reflection

What does “alignment” mean to you personally?

Is there anything else you’d like me to know before we connect?

Did someone refer you?

I have a referral program in place, where you and the person who referred you receive 20% off their coaching program.

Please share who referred you so that I can let them know. Thank you!

referral

🌿 Thank you for taking the time to share your story and energy with me.

Once your application is received, I’ll personally review your responses.

If it feels aligned, you’ll receive an invitation to schedule your Alignment Discovery Call, where we can explore what your journey could look like together.

With gratitude,
Karen