Application form - Pain to Power
If you would like to be part of the Pain to Power journey, please fill in the form by latest by 30th August 2016.

Below, please share as much as you feel comfortable sharing. There is no min/max length for responses and no pressure. We only ask you to share what you feel is ‘enough’. Your answers are confidential. Don’t worry too much about grammar or style. We will follow up with more questions or a phone call if we need more information.

Name *
Your answer
Email *
Your answer
Contact Number *
Your answer
Address
Your answer
Age *
Your answer
1. How do you identify? *
This includes many aspects of your identity, such as gender, sexual orientation, caste, economic class, mother-tongue, religion or anything else that makes you who you are, by birth or by choice.
Your answer
2. What are your current areas of challenge and growth? *
We ask because we would like to include participants who can really benefit from this program. This would also help us design the process according to participant needs.
Your answer
3. Please share an experience that you feel shows what role your gender plays in your life. *
We simply want to understand you and your life better.
Your answer
4. Why do you want to participate in Pain to Power Program? How may this experience be valuable for you? *
We want to ensure that the program is a good fit for your needs.
Your answer
5. Any additional thoughts, comments, or questions?
Your answer
This is not a competition or a race where we select the ‘best’ applications or judge whose work is ‘better’ and whose isn’t. However, we are limited to a maximum of 20 participants, and we wish to ensure that the program is a good fit for participants' needs, so that the potential of the space is enriched and it becomes meaningful for all.

Please feel free to contact us if you have any queries. We eagerly look forward to hearing from you.

Somesh Menon – somesh.pfp@gmail.com / +91 7838003038

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