Generating Transformative Change a transformative Leadership Program Application

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Generating Transformative Change

A Transformative Leadership Program


Thank you for your interest in GTC South Pacific and for considering embarking on this individual and collective program of transformation.

To begin your application, please fill in your contact details below (please type):


Your Name



City Post Code



Home Phone


Cell Phone




The steps for joining our program are:

  • Complete this application which consists of

    • Your personal details

    • Your statement of intent and questions relating to your background (p5)

    • Logistics and Payment information

    • Program Commitment and Liability release form

    • Deposit payment ($500)

  • Email your completed application to and pay the deposit

  • After we receive your application we will schedule and conduct a phone or Skype interview with you

  • We will confirm your enrollment

  • Once we have confirmed your enrollment we will send you an email invite to take the StAGES developmental level assessment – this is an online sentence completion questionnaire. Pre-reading for the first retreat / intensive will be sent out via e-mail prior to the first retreat.

If you have any questions please contact

Tamara +64-27-601-8399 or

John +61-419-843-488

We are looking forward to receiving your application.

Logistics and Payment information

This is the logistics information for GTC SP5 starting in August 2016 and finishing in June 2017.

Dates for the Retreats / intensives:





24 Aug – 28 Aug 2016

St. Josephs Retreat Centre, Baulkham Hills, Sydney, Australia Note: 5 days


01 Dec – 04 Dec 2016

Mana Retreat Centre, Coromandel

Auckland, NZ*


02 Mar – 05 Mar 2017

Mana Retreat Centre, Coromandel,

Auckland, NZ*


01 Jun – 04 Jun 2017

St. Josephs Retreat Centre, Baulkham Hills

Sydney, Australia

Please note: The intensives start at 9:30 and finish after Lunch (13:30)

* Unless you live in or near Auckland, New Zealand you will need to travel the day before the start of the intensive as Mana retreat centre is approx. 2.5 hour drive from the Auckland Airport. The road is quite steep & winding in parts and is best driven during the day.

* Please note the first retreat/intensive is 5 days, subsequent retreats are 4 days


The rate for GTC for each person is

A$ 9,500 for Australian residents,

  • GST will be added for AU residents to the AU portion of the program which is 50% of the tuition

NZ$ 9,500 for New Zealand residents,

A$ 9,500 for residents of all other countries.

There are limited concessions available.
If cost is a major issue for you please contact us.

An early registration discount of $500 is available if we receive your registration on or before July 11, 2016.

The fee includes

  • all materials and instruction,

  • All accommodation and meals while on intensives/retreat

  • access to online classrooms and

  • One coaching session between each retreat conducted by a member of faculty.

The fee does not include airfares or other travel costs, which are the responsibility of the participant.
Deposit: A non-refundable, non-transferable deposit of $500 is required with your application to hold your place in the course. To submit your deposit, please see the payment information on the following page.

Payment information

Balance: You must either pay the balance in full before the first retreat or choose a payment plan. If you prefer an extended payment plan, choose either option 2 or 3 as indicated below. Please read the Cancellation Policy carefully to understand your financial obligation.
Please choose a payment option below.
Option 1: Pay 100% of the balance before the first retreat.
Option 2: Pay 50% of the balance before the first retreat.

The remainder of your tuition will be due in 4 equal bi-monthly payments due

01 Oct, 01 Dec, 01 Feb 2017 and 01 April 2017
Option 3: Pay 20% of the balance before the first retreat.
The remainder of your tuition will be invoiced in 8 equal monthly payments
beginning Oct 1, 2016
If neither of these options suits you, please contact us.

Making Payments: You may make your deposit and payments for the program in the following ways:

  • Online by direct deposit into a bank account (preferred)

For Australia and other countries
South Pacific Integral Pty Ltd

BankSA BSB 105 015

Account number 132095440

For New Zealand
South Pacific Integral Limited

Kiwibank 38-9012-0732218-00

  • Mail a cheque to

South Pacific Integral Pty Ltd
5 Daly Street

Somerton Park SA 5045

South Pacific Integral Limited
61 Edenvale Cres., Mount Eden

Auckland, 1024

New Zealand

If paying by credit card is your only option, please talk to us. We run this program on a break-even basis, so it would be necessary for you to carry any associated fees.

Program Commitment/Cancellation Policy

Cancellations prior to two weeks before the starting date of the program are refundable minus the $500 deposit. If cancellation occurs between the starting date and two weeks following the first training retreat, 50% of the program fee will be forfeited. No refunds are possible after two weeks following the first retreat. If you leave the program during the course of the year any tuition balance you hold will be payable at the time you withdraw.

Liability Release Statement

GTC is an educational experience. It makes no therapeutic claims, and is not a substitute for direct professional medical or psychological care based on your individual condition and circumstances. GTC is designed to open you to new perspectives that may cause you to question and change various aspects of your thinking and your life. In participating in this program, you agree to enter at your own risk and agree not to hold Pacific Integral or South Pacific Integral responsible for your emotional or psychological wellbeing or for the results of any life changes you make during or subsequent to your involvement in GTC. Should you need therapeutic support, you agree to consult a qualified mental health care provider.

By signing and dating this form you agree to adhere to the payment schedule, the cancellation policy and the liability release statement.

I ________________________ (print name) agree that I have read, fully understand and agree to the payment schedule, cancellation policy, and liability release statement. In consideration of and return for the services, facilities, and other assistance provided to me by South Pacific Integral and ISN, I agree to assume and take upon myself all of the risks and responsibilities in any way associated with this program. I assure Pacific Integral that there are no health-related reasons or problems which preclude or restrict my participation in this program, and I release Pacific Integral and ISN (and their respective governing board, employees, and agents) from any and all liability, claims and actions that may arise from any perceived or real adverse changes in my interior or exterior emotional, mental or psychological state or life circumstances.


___________________________________ _________________

Signature Date

Please scan and email this page to

Personal Information and Statement of Intent

As an applicant to this program, we invite you to complete the following areas of this application form. There are many things to consider when embarking on a new adventure. We want to know as much about you as we can so we can tailor our design to your needs as much as possible. As a part of this application process a collaborative interview will be scheduled so that both parties can confirm that the fit is mutually appropriate.

The general theme of this section of the application is, “Personally and professionally, where do I come from and where do I dream to go? What is my commitment to that dream”?

On separate sheets please complete the following:

  1. Please describe any important personal history or critical life events that informed the beliefs and practices you presently use. Describe your present belief system with regard to your current or future work.

  1. Describe any educational programs or trainings you have completed that have contributed to your career path or that are relevant to this program.

  1. Please describe your aspirations for taking this program.
    Why do you want to take it?
    What do you want to get out of it?
    What outcomes or intentions do you hold for yourself?
    What is your vision for yourself as an agent for transformative change?
    What kind of work do you want to do?
    What scope, focus, and kind of impact do you want to make?

  1. Describe your current work situation and how it relates to your desire to be in this program.

  1. This is a rigorous program. Describe the support system or personal context that will support you through this program.

  1. We will be working as learning communities (learning systems in which the participants self-organize, collaborate and make new knowledge together). Please describe any experience you have with learning communities.

  1. Do you have any current or chronic health issues? Have received addiction treatment at any time? Have ever been diagnosed or treated for a mental illness (including Depression/Anxiety)? Please also disclose any criminal convictions.

  1. It is not unusual for beliefs (even fundamental assumptions about who one is and/or the nature of reality) to change as a result of engaging in experiential programs like this. What are your feelings about examining your beliefs and fundamental assumptions?

  1. What questions do you have for us?

GTC South Pacific Application Page

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