Holy Bone Immersion Application Form
Thank you for taking the time to complete an application form to be considered for a Holy Bone Immersion. These Immersions are flexible mentorship containers that can run anywhere between 3 and 9 months to suit your needs. It is my hope and intention that the process of filling out this form will be a deeply reflective and ritualistic experience for you. Please take your time completing it, and I will be in touch with you after you submit it to discuss whether this opportunity is a good fit for you! (Please note that Immersions are available to female-identifying people only at this time. Thank you!)
What is your name? *
What is your birth date? *
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Do you happen to know the place and exact time of your birth, too? If so, please share the details below. (If not, no worries. I'm mostly a curious cat!)
Do you identify as female? *
What is your email address? *
What is your mailing address? (This will be used to ship you an Inner Balance ear sensor if you go ahead with an Immersion.) *
What time zone do you live in? *
When are you most likely to be available to meet over Zoom for sessions and online ceremonies during your Immersion? (days of the week, time of day, etc.) Please be as specific as possible! *
Do you have an Apple or Android mobile device (phone or tablet) that can download the free Inner Balance app? *
Do you have preferred pronouns that you'd like me to use when addressing you? If so, please indicate them below.
What are some of your perceived gifts and strengths, particularly in relation to your sacral area at this time? How connected do you feel to your sensuality, sexuality, creativity, and fertility? *
What are some of your perceived challenges, weaknesses, or areas of concern in relation to your sacral area at this time? *
What excites you about undertaking a Holy Bone Immersion? *
What, if anything, makes you feel nervous about undertaking a Holy Bone Immersion? *
What hopes, dreams, agendas, or expectations do you bring to this Holy Bone Immersion experience? What are your ideal outcomes? What would be an ideal process for you to go through? *
Holy Bone Immersions can run from 3 to 9 months. Do you have an idea of how long you'd like your immersion to be? If so, please indicate your timeline below. *
Do you have previous experience with heart coherence, Breathwork, and/or PSYCH-K®? Please check all that apply. *
Required
Is there anything you'd like to share with me about your previous experiences with heart coherence, Breathwork, or PSYCH-K®?
Why do you feel drawn to working with me in this capacity? What about me or this Immersion opportunity resonates with you in particular? *
The total cost of a Holy Bone Immersion is $2000 CAD. What sort of payment plan would work best for you (intervals and amounts)? *
Is there anything else you would like me to be aware of before you submit this application? Is there something you feel is relevant to share at this point?
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