Couples Programme Request Form

Bring the Couples Wellbeing & Energy Education Programme to your community

Request Received

Thank you for your interest in supporting conscious relationships and community wellbeing. Our team will review your request and be in touch.

Programme Request

Fill in the form below and we'll get back to you to discuss bringing the programme to your location.

Don't fill this out if you're human:

1. Full Name *

2. Email Address *

3. Contact Number (with country code) *

4. City & Country where you would like the workshop to be held *

5. Are you applying as: *

Individual participant Couple Community organiser Organisation / Centre

6. Estimated number of participants (if known)

2–4 5–10 10–20 20+

7. Do you have a venue available? *

Yes No Possibly (please explain below)

Please explain your venue situation *

8. Preferred timeframe *

Within 1–3 months 3–6 months Flexible

9. What is your main intention for requesting this workshop? *

10. Have you or your partner had any prior experience with Pranic Energy Healing? *

Yes No

11. Any additional information you would like to share

I agree to the Privacy Policy and consent to my data being processed to handle this request.

Empowering the next generation through spirituality, wisdom, and service.

NPO Registration: 2021/460271/08