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Alison's Extraordinary Relationship Intensive Application


Preview Application and Check back for 2021 dates.



Each Participant Must Complete an Application
* indicates required field
Applying as *   
First Name *   
Last Name *   
Phone Number *   
Email Address * 
(confirm)  
Gender *   
Name of the Person you're in Relationship with *   
Co-Participant's Email Address   

(Required if you're applying as a couple)

Gender of the Person you're in Relationship with *   
Form of your Relationship * 

What is the form of your relationship? (Ex:Boyfriend/Girlfriend, Committed/not living together, Committed and living together, Married, Married/Separated, etc.)

 

How Long Together * 

How long have you been together?

 

If married, how long have you been married?

 

Children 

Children? If Yes, age and gender for each.

 

Quality of your Relationship * 

Please rate the quality of your relationship, for you, at this time, from 1-10, where 1 is "needs rescuing,"
5 is "okay, but wouldn't want to do this forever", 9 is "ready to go from good to great."

 

Relationship's Strengths * 

What do you consider to be the top 5 Strengths of your Relationship?

1.  

2.  

3.  

4.  

5.  

Frustrations/Problems/Concerns * 

What are your top 5 frustrations, problems or concerns in your relationship?

1.  

2.  

3.  

4.  

5.  

Results * 

What are the top 5 results you intend to achieve by participating in this Intensive?

1.  

2.  

3.  

4.  

5.  

Share with Partner? *  Will you share these responses with your partner?    
Anything Else? 

Anything else you'd like Alison to consider when reviewing your application?

 
Agree to Terms *  If accepted into the program, I agree to the Intensive Terms and Conditions.
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