One more - Points of You Indonesia

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Email Facilitator
Facilitator*
- Amelia Hirawan
- Priska Devina
- Ferlita Sari
- Mariati Budirahardja
- Ismarli Muis
- Henry Rahardja
Name*
First Last
How would you like to be called during the workshop (Do you have a nickname)?*
Date of birth*
DD slash MM slash YYYY
Gender*
- Female
- Male
- Non-binary
City & State/Region*
Country of residence*
Country of birth*
Cell-phone number:*
*Including Country Code Please make sure you have Whats-app downloaded onto your smartphone. We will use it for coordination and communication before and during the course.
Email address:*

Make sure it's one you check often, as this is one of the main ways we'll be communicating with you.

Workshop Information:
Name to appear on your certificates*
What is your profession?*
Do you have any accessibility issues that we need to be aware of? Any physical disability or difficulty?
If you do, please mention what it is and how we can assist you.
Do you have any dietary or allergies we need to be aware of? Gluten free/ Lactose sensitivity/ nut allergies etc.
Are you currently dealing with a medical condition that we need to be aware of?
If so, please mention what it is and if there is any way we can assist you.
Have you ever taken any medication (psychiatric or due to a medical condition)?
- YES
- NO
Are you currently taking any medication (psychiatric or due to a medical condition)?
- YES
- NO
Parts of the training might be recorded and photographed. While this is mostly for creating memories for you from the experience, we may use some photos for upcoming marketing purposes. Do we have your permission to photograph you during the training?*
- YES
- NO

Personal & Professional aspirations
What do I wish to gain from the workshop on a personal level?
What do I wish to gain from the workshop on a professional level?
In which field do I still have unleashed potential?
- Career
- Relationship
- Money
- Sexuality
- Family & Friends
- Health
- Personal growth
Is there something that you would like to share about yourself?

Logistic information
Which tools version do you want to have?*
- Bahasa Indonesia
- English
Name to appear on your receipt/invoice

If you'd like it to appear as the name you mentioned above, you can skip this question
Tax ID / VAT ID?
Billing address
Street Address City State / Province / Region Country

Terms and Conditions
Please note that by submitting this form, you are accepting that you have read and agreed to the following terms and conditions.
Professional & Marketing information news*
- I accept
- I don't accept
I agree that as part of the workshop registration I will share with the participants a form in which they will need to agree:
Share their personal details with Points of You Indonesia (full name and contact info) & Confirm receiving news, newsletters, and special offers from the Points of You Indonesia.
Liability agreement*
- I accept
- I don't accept
The Creative Practice workshop is an energitic, practical and creative workshop. This training is an opportunity to experiance a powerful professional and personal exploration of learning, reflecting, letting go and just being. Points of You® Academy official workshops are not a substitute for psychiatric, or psychotherapeutic treatment, but may complement a therapeutic process and facilitate. Points of You® always strives for every participant’s well-being, it is the responsibility of each participant to take care of themself. By submitting this form, you accept that you are solely responsible for your physical and mental well-being during the training and also for your personal items. I accept/ I don't accept
Cancellation Policy*
- I accept
- I don't accept
Recommendation for cancellation policy :
All the investment will return in credit points that can be used to apply another schedule of Points of You official workshop or Points of You tools purchasing.

Workshop Information:

Personal & Professional aspirations

Logistic information

Terms and Conditions