Name: ____________________________________________________________

Address: __________________________________________________________

Phone Numbers: H) ________________________________

C) _________________________________

Email: ____________________________________________

Birth Date, Place, Time: ______________________________________________

___________________________________________________________________

How did you find out about us?

Friend_______Family Member_______Email_______Intro_______

Website_______Event_______Other_______

7. What is your definition of global healing?
8. What does global healing mean to you personally?
9. What calls to you in your life?
10. On a scale of 0 to 10, to what degree do you honor and keep your commitments?
11.On a scale of 0 to 10, to what degree do you consider yourself teachable and coachable?
12. What is your background in personal healing work?
13. What is your background in social and/or environmental activism?
14. What is motivating you to apply for the Global Healing Forum Training Program?
15. How could you personally benefit from the Global Healing Forum?
16. What other gifts, talents and experiences will you bring to the Global Healing Forum?
17. What are your goals and intentions in joining the Global Healing Forum?
18. What are your expectations for joining the Global Healing Forum Training
Program?

Please email this application form to the Global Healing Forum at:
santondelavie@gmail.com, or call: 415-209-3882 to register or for more information.