ADMISSION COMMISSION SUBMISSION

Complete this form to submit your
Admission Commission

This form will capture information used to create a unique, custom piece of artwork that you can choose to purchase. Each artwork is based on input from 12 people. While I need to collect your name and email address to inform you when your piece is ready, your name will not be associated with your submission details. Participants will also receive a one-page handout highlighting all admissions anonymously.

Please complete this form in a quiet and peaceful place. Use the visuals below to guide your responses. Trust your intuition—you cannot be wrong in your selections during this process. Approach this as a fun experiment. You have nothing to lose by exploring new thoughts, beliefs, and emotions creatively. Don't overthink or worry about outcomes; release any expectations and self-judgment. Remember, you only control how you choose to feel and what you are drawn to. You cannot get this wrong, and you have nothing to lose!

Thank you for joining me in this creative and vulnerable space!

First Name

Last Name

Country

City/State

When the negative voice inside my head starts chattering, what I most often hear it say is that I'm......

When this happens, what I want to believe instead is that I'm....

The emotion I want to experience related to that new belief is.....(feel free to use the emotion wheel below)

The one color I'm most drawn to associated with this emotion is.... (reference the Basic Color Wheel chart below and pick one)

The one shape I'm most drawn to when I think about embodying this new belief and emotion is.... (pick one shape from the diagram below)

Thanks for your submission! You will receive an email when your Admission Commission is available to view and purchase.

Complete this form to submit your Admission Commission

Contact me at andrea@performore.biz with any questions!

Complete this form to submit your
Admission Commission