THIS BOOK SURVEY IS CLOSED Discussion Group Participation Personal InfoGeneral note: We ask for a lot of information here, hoping to match you with the best possible partners for the best possible experience. We promise our best efforts. We will take all this information into account, but we can’t know in advance how closely we will be able to match you with others with similar scheduling, interests, and backgrounds.Name* First Last Email* Location* City State / Province / Region AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Time Zone Possible Meeting TimesWhat days & times can you possibly meet? (Please choose as many as are realistic for you!) We imagine meetings lasting just 1 hour, 90 minutes or 2 hours, but please answer using multiple choice identifying 3-hour blocks of time. (Translate your local time to PDT / CA time.)Approximate time of day.* 12 AM - 3 AM PDT 3 AM - 6 AM PDT 6 AM - 9 AM PDT 9 AM - 12 noon PDT 12 noon - 3 PM PDT 3 PM - 6 PM PDT 6 PM - 9 PM PDT 9 PM - 12 AM PDT Choose as many as apply.Days of the week.* Saturday Sunday Monday Tuesday Wednesday AM Choose as many as apply. Note: Since new chapters are released Wednesdays at Noon Pacific, we do not include Wednesday evening, Thursday or Friday times, to allow time for you to read the chapter before your group meets.What I am good at and interested in (Rank in order):Rigorous intellectual discussionDeep feeling engagement with the implications of the ideasDeep listening and We-SpacePersonal support and bondingDrag & drop the above choices to rank in order.Personal Background(Please rate each 1-5, from low to high)History of deep psychological and spiritual work*12345History of reading and understanding Integral philosophy*12345Experience with we-space work*12345History of working with Terry Patten*12345I have already read A New Republic of the Heart*12345I am willing to support others in my group by committing to weekly meetings (missing as few as possible and definitely less than 25%).* Yes I am sincere and commit to participating in my group constructively. I will help create coherence as a practice. I do not have problems with mental health or addiction that might interfere with my ability to participate responsibly in my group.* Yes I understand that although the Terry Patten team will do its best to introduce me to other group members and support us with deepening questions and best practices, I realize that these will be self-moderated groups, and I accept responsibility for creating a successful experience for myself and my fellow evolutionaries. I realize that some people may respond a bit late and that this might affect the schedule of group introductions such that my group may not be introduced in time to discuss the earliest chapters.* Yes
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