Name *

First Name

Last Name

Phone

(###)

###

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Which upcoming workshop would you like to join? *

Wed, Jul 17 - Thu, Jul 18 | 10:30a - 1:00p and 2:00p - 4:30p CST (both days)

Thu, Jul 25 - Fri, Jul 26 | 10:30a - 1:00p and 2:00p - 4:30p CST (both days)

Fri, Aug 16 - Sat, Aug 17 | Friday: 10:30a - 1:00p and 2:00p - 4:30p CST | Saturday: 11:00a - 1:30p and 3p - 5:30p CST

What motivates you the most to take this workshop? *

I want to overcome limiting beliefs and patterns that hold me back

I seek to deepen my understanding of myself and my purpose in life

I believe in the power of inner work to transform my life for the better

I want to know what's in the way of reaching my goals and achievements

I'm taking it out of curiosity

I'm not sure

What types of personal development activities do you have experience with?

Check all that apply

Being in a Men's Group, Women's Circle or similar groups

Attending workshops, retreats, or seminars related to personal development

Participating in spiritual, meditative, or contemplative communities (e.g. Zen sangha, meditation circles, therapeutic communities of practice, consultation groups, religious or spiritual circles)

Working with a therapist or counselor

Working with a coach

Professional training that involves personal growth or inner work

Other