Conscious Dating Success Story of the Year Contest Entry Form

Conscious Dating Success Story of the Year Contest

Thank you for your interest in entering our Conscious Dating Success Story of the Year contest!

On February 14, 2009, the third anniversary of the publication of Conscious Dating, we will announce and publish the contest results and award an iPod Nano loaded with 20 of our best Conscious Relationship Audio Programs ($400.00 value) to the First and Second Place success stories (judged by the staff of Relationship Coaching Institute).

Important: Please note that you must certify that you have read the Conscious Dating book to qualify. All submissions become property of Relationship Coaching Institute and by entering this contest you grant us permission to publish your story online and in print.

I greatly appreciate your submission and hope that my book 'Conscious Dating' will help you find the love of your life and the life that you love.

David Steele, MA, LMFT, CLC
Founder, Relationship Coaching Institute and Network
www.relationshipcoachinginstitute.com
www.relationshipcoachingnetwork.org
Author, Conscious Dating: Finding the Love of Your Life in Today's World
www.consciousdating.com

Conscious Dating Success Story of the Year Contest Entry

Please note that all fields followed by an asterisk must be filled in.

Have you read the book "Conscious Dating?" (must respond "yes" to qualify- please stop here if you haven't read the book)*
Have you read the book "Conscious Dating?" (must respond "yes" to qualify- please stop here if you haven't read the book)*
Yes
No

What was the most helpful concept, idea, or strategy you learned from this book and why?*
What was the most helpful concept, idea, or strategy you learned from this book and why?*

Which of the Ten Principles of Conscious Dating was most instrumental in your success and why?*
Which of the Ten Principles of Conscious Dating was most instrumental in your success and why?*

Please share your biggest relationship mistake or blunder and what you learned from it*
Please share your biggest relationship mistake or blunder and what you learned from it*

Please share your success story in as much detail as possible*
Please share your success story in as much detail as possible*

Based upon your experience, what is the single most important advice you'd like to pass along to other singles?

First Name*
First Name*

Last Name*
Last Name*

E-mail Address*
E-mail Address*

Street Address*
Street Address*

City*
City*

State/Prov*
State/Prov*

Zip/Postal Code*
Zip/Postal Code*

Country*
Country*