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Person 1:
First Name _______________________________ Last Name ______________________
Middle ____________
| I am: |
Choose a nickname or pseudonym
_____________________ |
| ___ male |
|
| ___ female |
I want to use: |
| ___ couple |
___ my real name |
| ___ single |
___ my nickname |
| ___ married |
|
| ___ in a relationship but
attending as a single |
if you're in a
relationship, how long have you been together? |
| ___ in a committed relationship |
___ years,
___ months |
| |
|
*
Birth date: Month ________ Day ________ Year ______
Email _________________________________ Telephone: Home
(____)_______________________
Work Phone: (____)_______________________ Cell Phone:
(____)_______________________
Address: Street _________________________________ City:
_________________________________
State/Province: ___________________________ Zip: ______________ Country:
__________________
Occupation _______________________________________
If visiting Maui, how long will you be on island? _______ I live on Maui ______
full time, _____ months a year
I visit Maui ______ times every _______ years for _____ weeks or ______ months
______ I verify that I am at least 18 years of age*. Birth Date ___/___/
________
*(You must be 18 or older. Positive ID showing proof of age is required).
I am (pick the ones that best describe you):
| ___ Bi-Curious |
___ Heterosexual |
___ Polyamorous |
| ___ Bisexual |
___ Lesbian |
___ Sub |
| ___ Curious about the lifestyles |
___ Lifestyler |
___ Switch |
| ___ Dom |
___ Monogamous |
___ Straight |
| ___
Gay |
___ Playcouple |
___ Transgendered |
| ___ Other (Please describe) |
__ Voyeur |
___ Transvestite |
1. Describe yourself - your qualities, traits, characteristics and
challenges.
2. What would you like? (If more than one apply, number in order of preference).
_____ celibacy
_____ committed, exclusive, living together, primary relationship, one to one
_____ committed, exclusive, living together, primary relationship
_____ committed relationship polyamory (more than one)
_____ community - non sexual
_____ community - sexual
_____ discreet affair
_____ fetish (please describe _______________________)
_____ group marriage (many people committed to each another)
_____ group lovemaking
_____ intimate network (group of lovers that all know one another or know of one
another)
_____ line marriage (committed group, all ages)
_____ living alone
_____ living together
_____ marriage
_____ menage a trois (three way lovemaking)
_____ monogamy (married to one person)
_____ mono-poly (polyamorous couple who live together, date others as a pair)
_____ no definition, decide what’s right in the moment
_____ one on one sex
_____ playcouple (committed couple who play sexually with other singles and
couples)
_____ polyandry (one woman, many men)
_____ polyamory (loving more than one in an intimate relationship)
_____ polygamy (one man, several women)
_____ polyfidelity (closed circle of sexual intimacy)
_____ open relationship
_____ open marriage (married to one person, dating outside of marriage)
_____ serial monogamy (dating one at a time, for a limited time)
_____ single and dating (one person at a time)
_____ single and dating (more than one person at a time)
_____ swinging/lifestyles (sexual episodes)
_____ tantra/tantric (sacred sexuality)
_____ triad (committed threesome)
_____ uncommitted
_____ other (please explain) _________________________
3. Do you have any experience with tantra? If so, please describe
3A. Describe your first experience with masturbation.
3B. Describe your first experience with orgasm.
3C. Describe your first experience having sex with another person.
3D. Describe your first experience with intercourse.
4. What attracts you to the School of Tantra events and classes?
5. Do you hope to find a date or connect with someone at this party, group,
seminar or event?
I am seeking: ____ single man; _____ single woman; _____ couple; _____ triad;
_____ foursome; ______ group
6. What is your current relationship status?
7. Are you happy? To what degree?
8. If you’re not happy, what do you seek?
9. Are you and your partner(s) sexually active? _______ If not, is there a
reason? Please explain.
10. I want to be involved with my partner(s): _____ full time, ____ weeks or
_____ months a year
11. What are your attitudes toward nudity?
12. Would you be a) comfortable or b) uncomfortable with optional nudity at a
seminar or event you might attend?
13. What are your attitudes towards sexual behavior, orientations or
relationship structures different than yours?
14. Describe your boundaries and limitations around sexual interactions with
people you just meet (like, for instance, the people who come to the workshop).
15. Do you have children? ____ If so, how many? ______ Are they grown? _____ Do
they live with you? _____
16. Do you want children _____ If so, how many children do you want?______
17. Do you have pets? _____ If so, how many? ______ What kinds of pets?
18. Do you want pets ? ______ What kind of pets do you want? _____________ How
many? _____
19. Who was in charge of you when you were little?
20. If you were raised by a single parent, how did that affect you?
21. What did you lack in a parent that you would like to find in a lover?
22. How many siblings did you have?
23. What was your place in the birth order?
24. How did your place in the birth order affect you?
25. Describe the model of relating your parents showed you.
26. What did you think of your parents and the way they modeled relating?
27. Of what they showed you, what would you like to keep, discard or modify?
28. Describe two critical events in your growing up that affect you to this day.
29. What was the cumulative effect of your childhood on who you are now?
30. Describe two peak events from your past that affect you to this day?
31. What are the different roles or aspects of your personality that you must
balance?
32. Imagine (or remember) a pastlife you had. What scripts from that life still
run through your current existence?
33. What were the religious or spiritual practices that you were taught when you
were young?
34. Did you follow those practices or rebel against them?
35. What are your religious and spiritual beliefs and practices now?
36. How do you follow your religious and spiritual practices?
37 Describe your physical appearance. Attach photos, several if possible, to
show your many moods.
38. Height ____________ Weight _____________ Body Type ____________
39. What else would you like to tell us about your physical self:
40. Do you have any physical challenges and if so, do you need any special
considerations for these challenges?
41. Describe your Personality:
42. What are your best qualities?
43. What are your faults?
44. Are you a jealous person? If so, how do you handle jealousy?
45. Describe an incident where you were jealous
46. How did you resolve your jealousy?
47. What are your interests?
47. Describe your boundaries:
49. Describe your limitations:
50. Describe your expectations:
51. Describe your desires:
52. Describe your fantasies:
53. Do you have any fetishes? If so, please describe
54. Do you read? If so, what are your favorite books?
55. Do you watch television? If so, what are your favorite shows?
56. Do you like movies? If so, what are your favorite movies?
57. What kind of music do you like?
58. What do you seek in relationship?
59. What do they look like?
60. Describe their personality:
61 What do you do when you notice someone that you’re attracted to?
62. What are the qualities of your ideal mate?
63. What are their interests?
64. If everything turned out the way you wanted, what would that look like?
65. Describe your current sexual or intimate relationships:
66. Please tell us anything else about yourself that you think would be relevant
for us to know:
67. I’m interested in: Events, workshops, seminars or groups that meet:
___ Morning ____ Afternoon ___ Evening
___ All Day Events
___ Two Day Events
___ Weeklong Events
___ Certification Programs
___ Counseling/Coaching/Therapy
___ Group Events
___ Private Sessions
An orientation interview is required before admission to any of our
programs-groups, classes or events. The Annual School of Tantra Membership Fee
is $150 per single or couple which includes your application review,
orientation interview/Tantra Basic Class or private tutorial (see list below).
The following private tutorials serve as substitutions for your orientation
interview
(choose one)
___ Annual Life Review and Introspection
___ How to Really Love A Woman
___ How to Really Love A Man
___ Orientation Interview
___ Tantra 101
___ Polyamory 101
I
would like to sponsor:
___ single woman
___ single man
___ couple
___ male partnered but attending as a single
___ female partnered but attending as a single
I want to help them with: ___ Tuition, ___ Transportation,
___ Meals, ____ Accommodations
I
can contribute $__________ towards their expenses
___ I need a sponsor:
I need help with: ___ Tuition, ___ Transportation,
___ Meals, ____ Accommodations
I
can contribute $__________ towards my own expenses
Are you a current School of Tantra Member? Y/N ____ If so, when did you register?
______________
Membership number ______
When does your membership expire? __________
Event Name 1) ________________________________ 2)
_______________________________________
Dates Attending 1) ______________________________ 2)
______________________________________
Payment: Check ____ Money Order ___ Master Card ___ VISA ___
Credit Card Number _______________________ Expiration Date _________
Signature _____________________________________________ Name on Card
__________________________
Allow sufficient time to schedule and complete your Orientation Interview/Tantra
Basic Class so that you’ll be admitted to the group or class you wish to attend.
Master Card, VISA, check or money order accepted. Check must be received at
least one week prior to the event you’re attending so it may clear the bank.
Mail this form along with a copy of your ID showing proof of age and payment to
the address below so that we may review it before your appointment. Call
808-244-4921 to schedule your appointment.
Date/Time I want my appointment _________________ AM/PM
____ Phone, ___ In Person
___ Group Orientation: Friday, 5PM.
I want to attend my interview:
___ by myself
___ with ________________________ (name of person)
Payment: Check ____ Money Order ___ Master Card ___ VISA ___
Credit Card Number _______________________ Expiration Date _________
Signature _____________________________________________ Name on Card
__________________________
Payment in full required before admission service, group, class or function.
SCHOOL OF TANTRA, PO Box 2973, Wailuku, Maui, HI 96793, 808-244-4921
web site: www.schooloftantra.com, email:
schooloftantra@aol.com
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