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Ready to Reimagine
Your Future?

The Power of Five

Application Form

Section 1: Your Profile

First name

Last name

Preferred Email

Phone

City

State

Section 2: Current Status

*** ALL INFORMATION PROVIDED IS CONFIDENTIAL & IS STORED IN A ENCRYPTED DATABASE ***

Are you currently Employed?

Yes

Recently Laid Off

If employed, please describe your current role:

*Name of Employer is not required.

If unemployed, when was your most recent position, and what was the title?

Name of Employer is not required.

Section 3: Motivation & Goals

What inspired you to apply for the Power of Five? (100 words or less)

What outcome would make this experience a success for you?

On a scale of 1 to 10, how committed are you to investing time and energy in your reinvention?

Section 4: Logistics

Will you be able to attend all four evening sessions?

(It is required to attend all four sessions in order to qualify.)

Are you available for a brief video interview prior to final acceptance?

Section 5: Scholarship Consideration (Optional)

(As part of our pilot launch, a scholarship will waive the full $249 program fee—making participation completely cost-free for selected individuals.)

Are you interested in being considered for a fulll scholarship due to a financial hardship?

If yes, please explain briefly (100 words or less):

Final Notes

Each Power of Five class is highly selective - only five participants from highly motivated applicants from across the country will be accepted.

We review applications with care and follow up promptly.

Be prepared to step into a future you may not have yet imagined.

Ready to Reimagine Your Future?