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Power Hour Circle
Application Form

Will YOU be part of the Millionth Circle that changes the world?

You can participate in a Power Hour Circle if you will commit to all 10 of the "I will agree to" statements below. Please fill in the requested information and then use the submit button at the bottom of the form to complete your application.

My full name is:
Today’s Date is:
My email address is:
My phone number (including area code) is:
So that we can match you up with women in your area, please tell us what city and province/state you live in:
City:
Province/State:
I will agree to:
1) Become part of a circle of 5 to 8 women.	Yes No
2) Meet for 8 weekly 1 ½ hour gatherings.	Yes No
3) Endeavor to be at every gathering (advising my Circle members when I cannot attend)	Yes No
4) Complete the full evaluation process at the end of every gathering (consists of a verbal discussion and completion of a written evaluation form)	Yes No
5) Share my contact information with the women in my circle.	Yes No
6) Be a Circle Guide* for at least one of the 8 gatherings (see details below)	Yes No
7) Provide a quiet space, free from interruptions for our Power Hour Circle to meet, for at least one of the 8 gatherings (living room, kitchen, friend’s house, meeting space… whatever can be arranged)	Yes No
8) Provide DVD/TV and CD players for the meeting I host OR Provide a computer with high-speed internet access and speakers for the meeting I host	Yes No
9) Read and agree to begin living by the Code of Honor (Click here to view.)	Yes No
10) Consider making a weekly donation (whatever amount I feel is suitable) to help offset the rather substantial technical and labor costs of preparing, editing and delivering the audio/visual program materials to me and my group	Yes No
My preferred time slots are (#1 being fist choice, #2, second choice & #3 third choice). I am indicating only the times I will be able to commit to. (i.e. you may have only 1 or 2 choices listed):
9:30 -10:30 am
Noon to 1:00 pm
1:30pm – 2:30 pm
7:00pm – 8:00 pm
Here are my top three preferences for days to gather (#1 being fist choice, #2, second choice & #3 third choice). I am indicating only the days I will be able to commit to. (i.e. you may have only 1 or 2 choices listed).
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Bonus Question: Are you able to provide a meeting space that is pet-free? (Not mandatory, but appreciated to accommodate those with pet allergies.)	Yes No

*The role of the Circle Guide:
The intention is to have one person responsible for distributing the learning materials, starting the learning program and other small assigned duties. It is an easy, but important responsibility. We trust in the power of the universe, therefore we will use a system to randomly select the Circle Guide for each week.

Thank you so much for considering participation in this pilot. Together, we can change the world!

In love and light,
Tina Thrussell
Founder, Universal Circle of Women

P.S. Would you consider finding 5 to 8 women to run your own Power Hour Circle pilot?

If so, co-ordinate them all, agree on a time to begin, then send us an email to tina@universalcircleofwomen.com.

Please include:

Your Name, phone number and email address as host of the Circle
The list of women you would include in your Circle, including their
Names, phone numbers and Email addresses
Day of meeting
Time of Meeting

We’ll contact you and arrange for you to receive the materials so you can begin your own Power Hour Circle.

We also have a handy Circle Convener's Guide to make generating your own circle as easy as 1-2-3. Click here to download this guide.

Namaste!

Power Hour Circle Application Form

Power Hour Circle
Application Form