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Application for Awakening Into Intimacy Retreat September 26-October 2, 2022 Application
Please complete this form in full with as much detail as possible. Couples must each complete the application form separately.
Questions? Contact: Christopher@Sunyata.info
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Email
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Your email
Name
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Your answer
Mobile Phone
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Your answer
Birthdate
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MM
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DD
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YYYY
My gender is:
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Male
Female
Other:
Occupation
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Your answer
Person to contact in case of emergency
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Your answer
Phone number of emergency contact
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Your answer
Do you plan to attend with a partner? (please each submit separate application questionnaires)
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Yes
No
How did you hear about this Intensive?
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Christopher Sunyata
Karlene Sunyata
Nina Lombardo
Facebook, Instagram or other social media
Other:
Required
If attending with a partner, what is their name?
Your answer
List the events and training with Christopher Sunyata, Nina Lombardo, or related teachers, that you have attended, if any. (Include what, when, and where, if possible.)
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Your answer
Have you participated in any other training programs for personal growth? If yes, which ones?
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Your answer
What are the three things, relationships, or areas of life you’d most like to shift or bring change to as a result of taking this workshop? What are your intentions for yourself and your future?
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Your answer
What would need to happen for you to feel that this workshop was a success for you?
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Your answer
The practices, training, and exercises in this workshop can be physically and emotionally demanding. Do you have any medical conditions that might restrict your full participation in this workshop? If yes, please explain.
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Your answer
Have you in the past two years been under the care of a therapist or mental health professional? Have you ever experienced any traumatic or emotional conditions that are relevant to this workshop, including childhood emotional or physical abuse? If yes, please share those circumstances in detail, when they began and their duration, including whether or not you received or are currently receiving treatment.
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Your answer
Do you have a regular spiritual practice such as meditation, prayer, yoga, etc.? If yes, please describe.
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Your answer
Is there anything else that may be important for Christopher, Karlene, Nina, and the support staff to know about you?
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Your answer
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