Shanenawa Immersion Application Form

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Please fill out this application form to be considered for the Shanenawa Cultural and Spiritual Immersion experience. We have two dates, so please inform which date you are interested in. 1. September 18-28 or October 20-30.

Due to the challenging nature of the trip and limited spots available, not all applicants will be accepted. Selection will be based on suitability for the trip, including physical fitness, outdoor experience, and alignment with the trip’s goals and values.

Email *

What date are you applying for? *

September 10 to 28

October 20 to 30

Required

Full Name *

Phone Number:

Date of Birth

YYYY

Nationality

Emergency Contact Name

Emergency Contact Phone Number

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