I'm so excited to have you join me for my Leading Your Teen 5-week telecourse. I'd love to get to know you and your situation better, please answer these few questions. All answers  are confidential.
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What is your name?

 
What's your best phone number?

 
Who lives with you and what are the ages of your children?

 
Which class time works best for you?


 
What do you hope to get out of this class?

 
What is your teen struggling with the most?

 
What are YOU struggling with the most?

 
What is your mailing address?

 
Is there anything else you'd like me to know?

Thank you so much for your interest in my Leading Your Teen 5-week teleclass! 
All calls are in Pacific Time Zone but will be recorded and sent to those who are registered.
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