Consultation Request Application

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Are You A:

Which Service Would You Like To Request?

What Would You Like From The Services?

What Would Be The Desire? (ie: when would it start, what would success look like, what would your life or business to be doing that it’s not now, and what social impact would come, etc.)

How many people would this involve

Is This A Faith or Spiritual Based Request?

Email

Name- first and last

My Role Is: (ie: parent, child, individual, role in organization with org. name)

What Time Zone Are You In

If Necessary, A Phone Number

Website If Applying For An Organization

Extra thoughts?

Upload a screenshot if needed

Drag and drop or click to select a file.

This form is to share the information necessary for your consultation.

Contact For Questions

Rediscover “You” In Life, Love, or Business, So “You” can change the world.

Get in touch

Samantha Santiago, PhD, M.B.A.
Open: Tuesday – Friday
hello@confidencefaith.com
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