The 6-month Leadership Program for Aspiring Change Makers Questionnaire

The 6-month Leadership Program
for Aspiring Change Makers
Application Questionnaire

Solu Khumbu, Eastern Nepal

Name(Required)

First Last

Age(Required)

Email(Required)

How did you hear about us?(Required)

Please tell us a little bit about yourself.(Required)

What identities, roles, and relationships do you inhabit? (eg. race and ancestry, pronouns, work/vocation, study, significant experiences relevant to this program, etc.)

Why do you feel that this 6-month program is important for your path right now? What do you hope to receive? What do you hope to bring to this community?(Required)

If you were to carry an Earth Treasure Vase, to which place and purpose would you like to dedicate it? Why?(Required)

This does not need to be a final decision, this is a place to share your inspiration.

Stewarding an Earth Treasure Vase can be a demanding spiritual journey and asks for a long-term commitment beyond this 6-months program. Are you willing, ready and able to invest the time and energy this will take? Are there any concerns you have?(Required)

If you are unfamiliar with Earth Treasure Vases, or what this commitment entails, please watch the info session, or reach out to Lisa at drlisahendrick@outlook.com.

What else would you like us to know about you?

Do you have any questions or concerns?(Required)

The 6-month Leadership Programfor Aspiring Change Makers Application Questionnaire

The 6-month Leadership Program
for Aspiring Change Makers
Application Questionnaire