The Temple of the Cosmic Dreamer Application
Thank you for your interest in the Temple of the Cosmic Dreamer.

This 9 month program will help you define, lean in and create your heart’s desire. You will learn tools that will help you discover,  release and create right relationship with any obstacles or perceptions that create drag or sabotage the creation of your heart’s desire.  

This application serves to help you become clear while it relates to me your level of commitment and dedication to yourself and your heart’s desire. Once completed and reviewed you will be sent a link to schedule a call to review your application with me.

Please allow yourself the space and time to read, contemplate and feel into the answers - if there are unknowns, it is ok to say you don’t know- we will discuss on your call.
Sign in to Google to save your progress. Learn more
Email *
First and Last Name *
Phone Number *
What is your Location/Time Zone *
What is your heart’s desire that you are ready to create? *
If you created your heart’s desire, who would you see yourself being? *
What are your 3 biggest challenges that have stopped you from creating and living your heart’s desire? *
How willing are you to lean into discomfort, take a risk, and create your heart’s desire *
Not Willing
100% Willing
How committed are you to be a stand for yourself and your heart’s desire? *
Not Willing
100% Willing
Being in committed action, how willing are you to invest in your  heart’s desire- time, money, resources? *
Not willing
100% willing
Please share any other information about yourself that will illuminate who you are and your commitment to your heart’s desire *
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy