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Do you have any physical disabilities or limitations due to injuries, surgery, congenital conditions, disease, or condition (such as allergies or pregnancy)? Please let us know of any health or medical issues that are important for us to know about. *
Are you being treated, have you ever been treated, or have you experienced (currently or in the past) any mental or nervous condition, including mental or emotional illness, personality disorder, addiction, anxiety, depression, or suicide attempt? Are you taking any prescription medication? If so, please give details. *
I represent that all of the information provided in this Application is true and correct to the best of my knowledge, and is being relied upon by POL Global Foundation Ltd in deciding my acceptance into this Awakening of Love and/or Introductory Work process.