Application Form

Please review the following video on how best to fill out the following Application

50% COMPLETED

APPLICATION FORM

Let's Get to Know You

please fill out the form below in its entirety so that we might get the ball rolling...

How ready are you for change?

Completely readyHalfway readyNot ready at all?

Have you had coaching before?

YESNO

Are you a single mother?

YESNO

Have you experienced domestic violence?

YESNODONT CARE TO SHARE

I would like to receive future communications

I agree to the GDPR & CCPA Terms & Conditions

I confirm that I am at least 16 years of age or older

I have read and accept any EULA, Terms and Conditions, Acceptable Use Policy, and/or Data Processing Addendum which has been provided to me in connection with the software, products and/or services.

I have been fully informed and consent to the collection and use of my personal data for any purpose in connection with the software, products and/or services.

I understand that certain data, including personal data, must be collected or processed in order for you to provide any products or services I have requested or contracted for. I understand that in some cases it may be required to use cookies or similar tracking to provide those products or services..

I understand that I have the right to request access annually to any personal data you have obtained or collected regarding me. You have agreed to provide me with a record of my personal data in a readable format.

I also understand that I can revoke my consent and that I have the right to be forgotten. If I revoke my consent you will stop collecting or processing my personal data. I understand that if I revoke my consent, you may be unable to provide contracted products or services to me, and I can not hold you responsible for that.

Likewise, if I properly request to be forgotten, you will delete the data you have for me, or make it inaccessible. I also understand that if there is a dispute regarding my personal data, I can contact someone who is responsible for handling data-related concerns. If we are unable to resolve any issue, you will provide an independent service to arbitrate a resolution. If I have any questions regarding my rights or privacy, I can contact the email address provided.

×

ABOUT US CONTACT US PRIVACY POLICY TERMS OF USE

© Copyrights by Mama's Cookin' LLC All Rights Reserved.

We use cookies to improve our service, track analytics, remember preferences, etc. By using our site, you consent to these cookies.

Privacy policy Cookie policy

Accept all cookies

Only essential cookies