NEW MEMBER APPLICATION
Business Disruption + Domination
To be considered for membership starting in September 2022, complete the quick application form below.
Please double check that your details are correct before you submit as I'll use these to contact you with the outcome of your application.
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Best email address (double check this is correct!)
Mobile Phone (including country code)
City and country where you're based?
Which membership are you applying for?
Defiant Mover Membership ($1950 in full OR 6 monthly payments of $400)
Defiant Mastermind Membership ($7950 in full OR 6 monthly payments of $1600)
How long have you been in business/freelancing?
0 to 1 years - I'm just getting started
1 to 3 years - I've found my feet, now it's time to ramp things up
3 to 5 years - This is my jam. I'm ready to go full speed.
More than 5 years - I'm deep in this. Let's go to WORK.
How would you describe what you do as a "Job title"?
Company name (or your brand name)
Industry you primarily serve
Choose from this list
Agriculture, animals and food
Science, environment and construction
Healthcare, wellbeing and sport
Creative arts, fashion and media
Government, law and education
Accountancy, finance and insurance
Business, sales and tourism
Charity, social work and religion
What's been your experience of coaching and/or online communities so far?*
What are you hoping to bring to The Defiant Movers Society?
What are you hoping to gain from The Defiant Movers Society?
Where can I find out more about you online? (website and/or social media)
Where did you hear about The Defiant Movers Society?
I agree to the storage and handling of my data by The Defiant Movers Society. I am also happy to be contacted by Coach Kym via telephone or email (opt-out any time.)
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