Fire of Love Experience Mini-Council: Getting Unstuck and Getting to the Heart of Your Life's Great Work!

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thanks for applying to join the Fire of Love Mini-Council happening on this Tuesday August 28th: 6-7:30pm Pacific Time. Your answers will help create a better experience for you and all participants. There are no right or wrong answers!

The Fire of Love Experience is a private community-based program -- launching soon -- dedicated to helping our members live amazing lives of fun and adventure, and produce your greatest work. All participants who join this mini-huddle will be automatically accepted to the program, and will have their payment refunded from the entrance fee if they choose to join the full program when it launches.

First and Last Name *

Phone Number and Area Code *

Please list international calling prefix if international.

Email *

Your information will not be shared and is always held confidential.

Where are you feeling stuck in your life? *

What kind of creative work would you really like to be doing at this time? *

What do you feel is your life's great work? *

Put another way, why do you think you were put here on this earth.

List 3-5 adjectives that describe you at your best...

List 3-5 adjectives that describe you at your worst...

What do you hope to take away from your experience in this group mini-huddle? *

Do you have a website? *

Please list the URL. If you don't have a website now, do you plan to build one for yourself in the future?

Are you comfortable sharing your challenges and your heart-song with a group of like-minded people? *

All participants agree to maintaining confidentiality of all that is shared.

Do you agree to the terms of the following liability disclaimer? *

Disclaimer: You must not rely on the information you receive from Satya Colombo, his staff, or any other members of the group, as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information you receive from Satya Colombo, his staff, or any other members of this group.

Yes

Any other questions or thoughts you'd like to share?

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Forms