Thanks for your interest in The Energy Takeback!
Once you submit this form, we will follow up with more details and next steps. Enrollment is dependent on the number of slots still available at the time of your submission.
Full Name *
Preferred Email Address *
What time zone are you in? *
Which session do you prefer?  If you can do either time slot, please indicate that. The sessions will be on Thursdays: July 7, 14, 21 and August 4. The days between session 3 (July 21) and session 4 (August 4) is used for the 30 minute one-on-ones. You will receive more info about scheduling those once the program starts. *
How did you hear about the Energy Takeback? *
Describe a community (of any size and context) that you are part of and is important to you. How does being part of that community impact you? *
What resonates with you about The Energy Takeback? What is an intention you have for your energy? (examples: become more aware of how to avoid negative energy, identify what fuels my energy so I can recharge, be more intentional about how I spend my energy, etc.) *
Are you able to pay the participation fee of $375?  Your response to this question will not affect your eligibility to participate. It will be used to identify the next steps for your enrollment. *
The Energy Takeback is rooted in generosity and reciprocity. If you are unable to make a financial contribution at this time, in what other way can you contribute?
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