The Reclamation Program Application

6-Month Journey: February 2026 – July 2026 | Limited to 8 Women

Welcome

Thank you for your interest in The Reclamation. This application helps us understand if this program aligns with where you are right now.

Please answer honestly—there are no “right” answers. Your responses are confidential and will guide our clarity call conversation.

Estimated completion time: 10-15 minutes

Discover Your True North at Midlife Signup - The Reclamation

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URL

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Contact Information

Name(Required)

First Last

Email(Required)

Phone(Required)

Billing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Time Zone(Required)

How did you hear about The Reclamation?(Required)

Instagram

Facebook

Web search

Past participant

Other

Your Current Reality

Age Range(Required)

38-45

45-55

55+

Current Primary Role(s):(Required)

Check all that apply.

Corporate Executive/Professional

Entrepreneur/Business Owner

Manager/Director/Team Lead

Individual Contributor (Specialist/Expert)

Primary Caregiver

In transition/between roles

Other

If Other selected, please explain further.

In 2-3 sentences, what does your life look like on the surface?(Required)

What have you built/achieved?

In 2-3 sentences, what does it feel like underneath?(Required)

What's the gap between external success and internal experience?

The Whisper

Complete this sentence: "I've checked all the boxes, but..."(Required)

What's the persistent whisper you keep hearing?(Required)

That feeling that says "there must be more than this."

If no one was watching and you couldn't fail, what would you want for your life?(Required)

Your Crossroads

Why now?(Required)

What brought you to this application at this particular moment?

What's the cost of not making a change?(Required)

If nothing changes in the next year, how will that feel?

On a scale of 1-10, how ready are you to prioritize yourself?(Required)

1-3 (Not ready—too many obligations)

4-6 (Interested but uncertain)

7-8 (Ready—willing to make space)

9-10 (Absolutely ready—I must do this)

Your Vision

If you complete The Reclamation successfully, what will be different about your life in July 2026?(Required)

How will you know this program was worth the investment?(Required)

What outcome would make you say "that changed everything"?

Experience & Approach

Have you done coaching or personal development work before?(Required)

Yes, extensively (multiple programs/coaches)

Yes, some experience (1-2 programs)

Minimal experience (workshops/books only)

No, this would be my first

If yes, what was most valuable about that experience?

Are you comfortable with vulnerability in a group setting?(Required)

Yes, very comfortable—I thrive in intimate groups

Somewhat comfortable—depends on the group

Uncomfortable but willing to try—I see the value

This concerns me significantly—I prefer 1:1 work

Are you currently working with a therapist, coach, or other support professional?(Required)

Yes, therapist

Yes, coach

Not currently, but have in the past

Other

Schedule & Commitment

Please review the program structure details on this page (https://cheleseperryllc.com/reclamation-discover-your-true-north-at-midlife).

I have reviewed both schedules and can commit to attending at least 9 of 11 sessions:(Required)

Yes, I've reviewed and can commit

No, I have conflicts with more than 2 session dates

Unsure—I need to check my calendar more carefully

Which cohort works best for your life?(Required)

🌤️ Weekend Cohort (Saturdays, 10:30 a.m.–12:00 p.m. ET)

⭐ Weekday Cohort (Tuesdays, 6:30–8:00 p.m. ET)

Either works for me

I have conflicts with both—please contact me

Do you have any known scheduling conflicts with the dates listed?

Vacations, work travel, standing commitments

What might get in the way of you showing up consistently?(Required)

Check all that apply.

Work demands/unpredictable schedule

Caregiving responsibilities

Time zone challenges

Energy/capacity concerns

Guilt about prioritizing myself

Fear of vulnerability/group work

Financial investment weighing on me

Nothing—I'm committed to protecting this time

Other

If you selected Other, please explain.

How will you protect your commitment when obstacles arise?

Investment

Early Registration: $6,500 (closes December 15, 2025). Standard Investment: $7,500 (closes January 15, 2026). A $1000 non-refundable deposit will be due upon program acceptance.

Which statement best describes your readiness?(Required)

Ready to invest—this is a priority for me

Willing to invest but need to make financial adjustments

The investment is a significant stretch but possible

I need to discuss with my partner/family first

The investment is prohibitive at this time

If accepted, when would you be ready to complete registration?(Required)

Immediately (within 24-48 hours)

Within one week

By December 15 (early registration deadline)

After December 15

I need more time to arrange finances

Your Commitment

Complete this sentence: "If I'm accepted into The Reclamation, I commit to..."(Required)

On a scale of 1-10, how committed are you to discovering your True North?(Required)

Final Questions

What questions do you have about The Reclamation?

What concerns do you have about this program or journey?

Is there anything else we should know about you or your situation?

The Reclamation Program Application

6-Month Journey: February 2026 – July 2026 | Limited to 8 Women

Welcome

Discover Your True North at Midlife Signup - The Reclamation

Contact Information

Your Current Reality

The Whisper

Your Crossroads

Your Vision

Experience & Approach

Schedule & Commitment

Investment

Your Commitment

Final Questions

Schedule a Strategy Session

Contact

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