Path of Love Application Form

Please attach a photo (right side up) of just you, without your family, friends or pets. Thank you * (JPEG, 2MB limit)
Email *
Select the event you're
applying to *
First Name *
Last Name *
Preferred Name
Gender *
Date of Birth
(DD/MM/YYYY) *
Nationality *
Occupation *
Address 1 *
Address 2
Suburb/City/Town *
State/Province/Terr/Region
Postal/Zip Code *
Country *
Phone Number (Home) *
Phone Number (Mobile) *
Skype
How did you hear about Path of Love? Please be specific, such as: Article written in January in the Sydney Morning Herald, etc. If you were referred by a family member, friend, or other person, please share their name. Thank you. *
Are you interested in receiving our newsletters via e-mail? *
Yes No
Please answer the following questions. Your answers will be read by the organizer and the process leaders and will be kept confidential. It is an important to answer all questions honestly in order for us to help you decide if Path of Love is an appropriate group for you. Thank you.

1. Please list the personal growth work you have participated in including therapy groups, spiritual retreats and individual therapy. Please include if you have applied for or attended any Path of Love related workshops and give the approximate date and place (AOL, POL, etc.) *
2. Please indicate any physical, mental, psychological conditions or illnesses you or your immediate family members have had in the past or have in the present which required or require on-going medication and or treatment. *
3. Briefly write about why do you want to do the Path of Love? *
4. Anything else that you would like us to know? *
If you have a referral code, please write it here:
Please be advised that our process includes a personal interview, following our review of this application, to ensure that your application is complete, and that you are ready to fully participate in the Path of Love Process. Following the interview, you will advised of our decision on your application, and be provided with our Medical Information Form, Terms & Conditions and Questionnaire, which must be completed, reviewed, signed and returned to POL Global Foundation Ltd. Finally, a Declaration and Consent Agreement must be completed and signed at the beginning of the Path of Love Process to confirm that all of the information provided remains current and accurate.

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 the Path of Love process.

Signature

Signature *

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Schedule a call with one of our Retreat Advisors to learn more about the Path of Love 7-Day Retreat.

This link will take you to an external site, where you can share your contact information (such as e-mail and/or Skype Name, etc.) and schedule a call with one of our Retreat Advisors.

Schedule a call with one of our Retreat Advisors to learn more about the Path of Love 7-Day Retreat.

This link will take you to an external site, where you can share your contact information (such as e-mail and/or Skype Name, etc.) and schedule a call with one of our Retreat Advisors.

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