JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Application process to assess goodness of fit.
Please take a few minutes to help us both discover if this is best for you, or not.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
FIRST NAME...
*
Your answer
BEST EMAIL
*
Your answer
Did you read and fill out the SHAME FINDER?
*
YES.
Not yet. Will do next.
No, What's that?
Do not wish to take that step.
Required
What specific aspect of toxic SHAME did you identify (one of your TOP 3) that you would like to release on the weekend? (EXAMPLES ~ "Feeling Not Good Enough", "judging my wife as too needy" or "Judging myself as weak or too sensitive")
Your answer
What do you HOPE to feel more as you UN-shame...?
*
Your answer
WHO are you doing this for? And what do you wish to bring back to them?
*
Your answer
Any FEARS or CONCERNS about doing this with a group of men, virtually and in real time?
*
Your answer
Are you able and willing to attend ALL parts of this weekend?
*
CONFIRMED
MAYBE -- some issues.
Can NOT attend.
8 - 10pm FRIDAY, March 26th
2 - 4pm -- SATURDAY, March 26th
8 - 10pm - SATURDAY, March 26th
9 - 11am -- SUNDAY, March 27th
CONFIRMED
MAYBE -- some issues.
Can NOT attend.
8 - 10pm FRIDAY, March 26th
2 - 4pm -- SATURDAY, March 26th
8 - 10pm - SATURDAY, March 26th
9 - 11am -- SUNDAY, March 27th
Will you be able to make time in between the sessions to REST and digest the changes happening within you?
*
YES, I'll make time
NO, I plan to juggle work, parenting and everything else that weekend being scattered half the time...
Other:
Required
Do you UNDERSTAND and accept the pricing structure? REMINDER -- It is PAY-WHAT-YOU-WANT that is collected AFTERWARDS (according to means and also what you have gotten out of it.)
*
YES, I get it.
CONFUSED still.
Required
Do you agree to give an HONEST review afterwards?
*
YES, to be seen privately by the leaders. Only shared publicly with your oversight and permission.
NO.
Required
Any special considerations or requests to share?
Your answer
How ready are you to commit now?
*
Decidedly NOT, thanks
1
2
3
4
5
CERTAINLY YES!
THANK YOU for sharing your input.
Here's to more deeply POWERFUL and incredibly LOVING months ahead!
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Powerful And Loving (PAL).
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report