Facility Application
Facility Application
InPower Institute is an empowerment, health and wellness center that advances wholeness and well-
being at every level of the human experience. The Institute helps individuals and groups exercise
their power to create loving, healthy lives, families, communities and a vibrant, sustainable world.
InPower faculty and affiliates offer programs, workshops and services in five core areas: 1)
inner/spiritual development, 2) personal growth and mastery, 3) family health and wellness, 4)
community empowerment and connection, and 5) planetary well-being. If you are interested in
conducting trainings, providing services, or hosting events at InPower in any of these areas, please
complete this form or contact Rebeccah Bennett at 314-210-8123 or
[email protected] .
Background Information:
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First Name Last Name
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Street City State Zip
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Home Cell Email
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Dates / times you are requesting facility space: (Ex: My class will meet each Monday during the month
of May from 4-6 p.m.)
1st Choice:_________________________________________________________________________________
2nd Choice:_________________________________________________________________________________
3rd Choice:_________________________________________________________________________________
InPower Institute • 5400 Nottingham Ave., St. Louis, MO 63109 • A Division of Emerging Wisdom LLC
How did you hear about us?
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Emergency Contacts:
Please provide contact information for one person that can be notified in case of emergency.
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First Name Last Name Relation to you
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Street City State Zip
(_____)__________________ (______)________________
Home Cell
InPower Institute • 5400 Nottingham Ave., St. Louis, MO 63109 • A Division of Emerging Wisdom LLC