The Heroic Adventurer – Thailand Application Form If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required First Name * Last Name Age Email * Phone Number Job Title Why are you interested in attending “The Heroic Adventurer- Thailand? * What would you love to get out of this experience? * What makes you a good fit for this experience? * What’s your current lifestyle like? What kind of life are you most inspired to create? * What’s missing from your life and how do you keep it out? If you had a magic wand and could change *one* thing in your life, what would it be? What are 3 ways you stop yourself from living the life you’d love to live? How much income did you generate in 2013 and 2014 and what is your goal for 2015? What other personal growth programs (if any) have you done? What fears or hesitations do you have about coming on this retreat and why? Are you currently facing any health challenges? If so, what are they? If you were accepted into this experience, what would stop you from coming? If you could bring any person in all of history with you, who would you pick and why?