Welcome to DATING for KEEPS!

Teresa's coaching program has a 98% Success Rate. When they follow her advice, single men & women attract & KEEP the Love of their Life!

Everyone who has followed her Dating for Keeps advice is still happily together.

If you've invested more time in your career than you have in personal growth or interpersonal skills, then this program is for you.

If you're longing to be held, to love & be loved, cherished, and treasured, then this program is for you.

Weekly sessions make all the difference!

Please complete this application to
receive your free, 30-minute consultation.

Once received, we will be in touch as soon as possible.


Team Teresa
LOVE in the 21st Century
Dating for Keeps
San Francisco ~ San Diego ~ Washington, DC
+ 1 (415) 289-2213

Begin Request
What's your first name? *

Hi {{answer_20047797}}, nice to meet you.

What is your last name?

City/Country of Residence & City/Country for Work? *

What's your cell phone number, area code & number?

Area Code / Phone Number

Age Group *

What is your occupation? How long have you been doing this work? *

Which hobbies do you engage in most frequently? Quarterly, monthly, weekly, daily? *

What is your gender? *

What is your current relationship status? *

What is your coaching objective? *

What is your spiritual or religious orientation today? *

Location *

Any health Issues? *


Are you coach-able? Can you listen well? Are you willing to learn communication skills to express your needs & desires? *

Sign me up for individual or group lists. *

When would you like to begin? *

To see the greatest benefit from our sessions it is important that we meet or speak at a regularly scheduled time & that you practice your homework between sessions. Will your schedule allow you to set this time aside?* *


Consider how much money you've invested into your career...

Consider the benefits of learning relationship skills to last a lifestyle.

This includes family & friendships.

My Coaching Programs are $100-150/hr. depending on the package.

$150/hr for less than 4 hours each month.

$100/hr for 4+ hours each month.


Please read and indicate that you accept the following private session policies.*

1. Sessions require pre-payment in order to confirm appointment details & get discounted rates.
2. Sessions will begin and end on time, unless Teresa has the time to continues.
3. Cancellations more than 24 hours in advance will result in a credit for a future, private session.
4. Cancellations less than 24 hours in advance or "no shows" will forfeit the full session fee.
5. Single sessions must be used within 30 days of purchase date.
6. Packages with fewer than 16 hours must be used within six months of original purchase date.
7. Packages with more than 16 hours must be used in their entirety within 12 months of purchase date.
8. Hours are transferable. Refunds are not available.
9. Teresa Ann Foxworthy has the right to refuse or cease coaching anyone with whom she isn't comfortable. In such cases, unused coaching fees will be refunded.
10. All information given is held strictly confidential.
11. Client takes full responsibility for his/her relationships & well-being; before, during & after this coaching program.
12. Client realizes these sessions ARE NOT a substitute for any & all medical conditions, now or in the future. *

Almost done! Just one last thing.

LOVE in the 21st CENTURY programs are a journey into love, self-discovery, relationship goals, & dating skills.

This will be both relaxing & energizing.

As the weeks unfold, you will learn new interpersonal skills & discover a greater capacity for living life to the fullest.

Is this OK with you?

If so, I look forward to working with you.

If not, perhaps you'll keep this information,
and bookmark our website:


Kindest regards,

Teresa Ann Foxworthy
Dating Coach
LOVE in the 21st CENTURY
Website: http://Loveinthe21stC.com
Tel: (415) 289-2213
Email: Loveinthe21stC@Gmail.com


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