Join My Team

Vitality Network Application

Thank you for your interest in becoming a member of the Vitality Provider Network! Please complete the application below and our committee will review it within 48-72 hours. We will notify you via email of our decision.

Please complete the form in full, the information provided will be used to create a profile to share on the Vitality Team Page.

Note: Your company's products and/or services should offer a holistic wellness approach. This is a requirement for all providers within our network. If approved to join our team, a yearly fee will be required, and a reciprocal service/discount will be negotiated for the referral of clients between Vitality Team members. Considerations for dual seats for the same industry/service may be made but are not guaranteed.

Candidate Information
Name*
First Last
Phone*
Email*
Industry/Service/Product*
Company Name*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Website
LinkedIn*
Facebook*
Additional Social Media URLs
Describe your company's mission/vision.
Provide a short bio about yourself.
Please upload your Company’s logo and a headshot for your bio.
Drop files here or

Max. file size: 512 MB.

Donna has captivated many individuals over the years as a Speaker | Inner Healing Coach | Facilitator. Her healing gifts and lessons of how to live a holistic life of vitality have been positively received and implemented by many clients over the years.