Together We Rise

Midlife Awakening Member's

Referral Entry Form

Every Share = 1 ballot

You can submit this form every time you share Midlife Awakening in some way!

Let's make this a beautiful movement where midlife women everywhere are saying YES to themselves!

Each action = 1 ballot
You can submit this form each time you take a new action.

1. First Name *

2. Last Name *

3. Email Address *

4. Which action are you submitting this ballot for? *

I posted on Instagram and tagged Melanie

I invited someone to book a discovery call or to DM Melanie

I referred someone who joined the program

I have a meaningful conversation and shared the program

Other (please describe below)

-

5. What did you share and/or what inspired you to share *

6. Who (if it was an individual and not a shared post) did you share this with? Please provide their name....etc. so we're able to connect the dots when they reach out! *

www.melanierobinson.ca

Together We Rise

Together We Rise

Midlife Awakening Member's

Referral Entry Form

Referral Entry Form

Every Share = 1 ballot

You can submit this form every time you share Midlife Awakening in some way!

Let's make this a beautiful movement where midlife women everywhere are saying YES to themselves!

Each action = 1 ballotYou can submit this form each time you take a new action.

Each action = 1 ballot
You can submit this form each time you take a new action.