Interest form

Please fill in your name, e-mail address and phone number, indicate your interest in each of the programs and click on "Send" at the end of this form

Name E-mail Phone Country

Please indicate your level of interest in these programs and services. You need only answer the ones you want to answer.

Counselling With my commitment to confidentiality, empathy, being non-judgmental and having unconditional positive regard for you as my client, feel safe to be empowered by sharing your thoughts with another human being.
Level of interest:	Not interested	Some interest	Interested.	Very interested	I will do it.

Coaching Employ me as your accountability partner as you create what you want for yourself in your life
Level of interest:	Not interested	Some interest	Interested.	Very interested	I will do it.

Programs or workshops: Karaoke. For fun and entertainment, for learning the joys of singing, for self-confidence, self expression, expression of feelings
Level of interest:	Not interested	Some interest	Interested.	Very interested	I will do it.

Weight Loss This is a provocative confronting session that gives you an opportunity to question your current beliefs about weight loss and shedding excess body fat.Some of the concepts of Tom Venuto’s "Burn the Fat Feed the Muscle" will be presented.
Level of interest:	Not interested	Some interest	Interested.	Very interested	I will do it.

Money If this presentation was priced at $1000 would you still attend? If not, why not? Otherwise donate $1000 to Global Energy Network International and bring a receipt with you. If you do not bring a receipt, come along to learn from those participants who do.
Level of interest:	Not interested	Some interest	Interested.	Very interested	I will do it.

Should I stay or should I go? If you have ever asked yourself this question in any of your relationships, you can discover how to answer it for yourself Even if you have never asked, you can strengthen your relationship with the insights you gain by having the courage to ask it. Some of the concepts of Suzie and Otto Collins’ book "Should I stay or should I go?" will be presented
Level of interest:	Not interested	Some interest	Interested.	Very interested	I will do it.

Authentic Man Program While you know you are kind, warm and friendly, you may wonder why the women in your life want no more than just to be friends.
Level of interest:	Not interested	Some interest	Interested.	Very interested	I will do it.

Make every man want you. The secrets to being irresistibly attractive Reading some material from Marie Forleo’s book "Make Every Man Want You"
Level of interest:	Not interested	Some interest	Interested.	Very interested	I will do it.

Encounter with the lioness Are you courageous and up to this challenge or are you a wuss? Step up, take the risk and be empowered. "Are you a man or a mouse?" "squeak squeak squeak"
Level of interest:	Not interested	Some interest	Interested.	Very interested	I will do it.

Sex In what ways are you unnecessarily suppressing your natural healthy sexual expression? Which of those ways serve you and which ones don’t.?
Level of interest:	Not interested	Some interest	Interested.	Very interested	I will do it.

Health What are you allowing to stand in the way of you enjoying excellent health and vitality
Level of interest:	Not interested	Some interest	Interested.	Very interested	I will do it.

Pain Rather than being a miserable victim when pain occurs, we can use pain for what I believe is its intended purpose, to guide us in healing. In this workshop we can challenge our beliefs about pain and brainstorm some ideas about what to do when pain occurs.
Level of interest:	Not interested	Some interest	Interested.	Very interested	I will do it.

Other programs or workshops Create or have created a special program or workshop for you or your group
Level of interest:	Not interested	Some interest	Interested.	Very interested	I will do it.
What other program would you like? You can write other comments or feedback here.

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