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* 1. What is your gender?

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* 2. What is your sexual orientation?

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* 3. What is your age?

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* 4. Which of the following best describes your current relationship status?

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* 5. I would welcome the opportunity to unpack sexual experiences from the male perspective in a safe and supportive environment with experienced facilitators.

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* 6. I would be interested in a virtual retreat that teaches sacred sexuality for men.

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* 7. I'd feel comfortable discussing this topic with a group of no more than _____ men.

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* 8. For this type of conversation I'd be willing to commit to a  _____ day virtual retreat.

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* 9. I'd be willing to participate in up to _____ hours per day for the virtual retreat.

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