Apply for Blueprint 12™

Application | Blueprint 12™

Apply for private consulting with Dr. Laxley W. Stephenson. Complete this application before a discovery call or payment invitation. The Growth Signature Assessment™ is included with enrollment, so you do not need to purchase it separately.

Full name *

Email address *

Phone (optional)

Have you already completed the Growth Signature Assessment™? *

First growth or leadership goal *

Second goal (if known)

What is your biggest obstacle right now? *

Preferred days, times, and time zone *

Who expects to pay for your program? *

Sponsoring organization (if applicable)

I agree that A Collision With Purpose LLC may contact me about this application. *

Please do not submit confidential Growth Signature Assessment™ responses or sensitive personal information through this form. Your assessment insights will only be discussed with permission.

Program Investment

Standard program (self-funded): $1,997. Founding-client offer: $1,497 for the first ten accepted and enrolled clients, subject to availability. Organization-sponsored: $2,997 per leader, including a written progress summary for the sponsor, shared only with the participant's written consent. Optional three-payment plans for individuals: standard $699 × 3; founding $525 × 3. The Growth Signature Assessment™ is included in every option. All payments require individual approval and signed terms.

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Growth is not accidental. Growth is designed!

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Apply for Blueprint 12™

Application | Blueprint 12™

Program Investment

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