MasterHeart Application - Wave 6 Confidential Application for MasterHeart Wave 6 Membership! Thank you for taking the time to complete this MasterHeart Application. If you felt a “yes” that this is the right place for you, I assure you there is nothing to lose and much to be gained by following that nudge. The application must be completed in its entirety. If a question is not applicable, please write n/a in the space provided. My team and I are excited to read your responses and learn more about you... and hopefully welcome you officially to the MasterHeart program. Love and blessings, Christine Name First Last Email Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Business Name (if applicable)Type of Business (if applicable)Years in Business (if applicable)Website (if applicable)What inspired you to apply for the MasterHeart progrm and share your story/message in "Pebbles in the Pond - Wave 6"? Why is it important for you to be accepted into the MasterHeart? What’s at stake for you?* Describe what message you are here to share. What do you want to write about? What story/wisdom/expertise do you want to share in your chapter?* If you’re accepted into the program, what are your top 3 intentions for this eight-month journey?* What are the top 3 challenges/blocks you’d like to overcome - or shift - by participating in the MasterHeart Program and becoming a published author in June of 2017?* Please share a little bit about yourself. (Include both personal and professional experience.)* On a scale of 1-10, where 1 is 'not at all' and 10 is 'completely', how able are you to invest TIME and ENERGY into the MasterHeart program?*On a scale of 1-10, where 1 is 'not at all' and 10 is 'completely', how able are you to invest FINANCIALLY in the MasterHeart program?*What are the reasons for the numbers you entered above?* Is there anything else you’d like us to know while we are considering your application?