Shamanic Apprenticeship Intake Form

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Please complete this form to the best of your ability and provide as much detail as you are comfortable with. All of the information you provide is confidential. Please take the time to read all the information provided and sign below.

Email *

Name: First and Last *

Preferred Gender Pronoun:

Date of Birth:

Physical Address and Mailing Address if different *

Phone(s) Home/Cell *

Emergency Contact; Name/Relationship/Phone *

What interests you about studying shamanism and experiencing shamanic initiations? *

What do you hope to gain from taking part in this program? *

What prior shamanic workshops or training have you attended and who taught them? *

What were your most important learnings or insights from each of these? *

How do you use information from your prior workshops and training today, in your life? If not, what would help you to begin using these teachings? *

Describe your current spiritual life. How do you share your spiritual perspective with others? *

Is there anything else that you want us to know about you, that is relevant to your application? *

What health conditions are you managing that could impact your ability to take part in the program that we should be aware of, if any? *

Awakening to Spirit: Shamanic Apprenticeship and Initiation program can be an intense experience and you will work closely with others in the program. Please provide a reference for someone who can speak to your ability to work closely in community. Please provide Name, Phone and Email of your reference below: *

Please review the dates of our scheduled meetings below and confirm that you can attend: *

First Residential Meeting: September 9 - September 11, 2022 at Ferry Beach in Saco, ME

Second Residential Meeting: September 21 - September 25, 2022 at Ferry Beach in Saco, ME

Third Residential Meeting: November 9- November 13, 2022 at Wavus Campus in Jefferson, ME

Fourth Residential Meeting: April 4, 2023 - April 8, 2023 at Ferry Beach in Saco, ME

Fifth Residential Meeting: May 31, 2023 - June 4 , 2023 at Ferry Beach in Saco, ME **This date may be subject to change**

Yes I can attend all dates

Exceptions/conflicts/dates

Please note that meeting dates may be subject to change due to unforseen circumstances

Required

I am applying for the 2022 - 2023 Awakening to Spirit: Shamanic Apprenticeship and Initiation program taught by Jody Breton and Bri Andreoni. I commit to full participation, including attendance at all sessions except as previously stated above or by virtue of personal illness or emergency. I understand that this is a 10 month program and I am responsible for the 10 month tuition. I understand that a session may need to be rescheduled due to Covid-19 or other unforeseen circumstances and I will do my utmost to attend the rescheduled session. I agree to pay all tuition payments on time and know that I am responsible for the full tuition regardless of my ability to attend any given session. Should it be necessary to change the venue of a meeting space due to unforeseen circumstances, I agree to meet in a different venue, provided it does not create an undue hardship on my part. Upon acceptance into the 2022-2023 Awakening to Spirit: Shamanic Apprenticeship and Initiation program I will receive and complete a separate document detailing my tuition payment plan of which I am accepting responsibility. In return for my tuition payment of $3,995.00 payable in full (if paid in full a 5% discount will be applied) or in 10 monthly installments of $299.40 after a $1,000.00 non-refundable deposit is paid. I will receive a total of 5 teaching sessions as follows: *

One 3 day, 2 night in residence teaching session with double occupancy lodging and all meals provided. This meeting is currently scheduled at Ferry Beach in Saco, ME. (link to website) https://www.ferrybeach.org/

Three 5 day, 4 night in residence teaching session with double occupancy lodging and all meals provided. This meeting is currently scheduled at Ferry Beach in Saco, ME (link to website). https://www.ferrybeach.org/

One, 5 day, 4 night in residence teaching sessions with double occupancy lodging and all meals provided. These residential meetings are currently scheduled at the Wavus Campus in Jefferson, ME.

Instruction and group leadership by Jody Breton and Bri Andreoni.

Regularly scheduled Zoom 90 minute meeting conference calls; generally scheduled during the months when not meeting in residence with attendance exclusively for members of this program. These conference calls are optional and I am not required to attend. However, conference calls provide an opportunity for you to ask questions, clarify previously taught practices and to build community. Conference calls will be recorded and audio will be made available.

All handouts will be made available.

For questions that cannot be brought to the group calls, guidance via conference call or private communication with Jody Breton or Bri Andreoni may be available upon request.

I look forward to a private interview with Jody and Bri at a time that will be set between us after completion of this application.

If I am accepted, I understand and agree that the cost of the program is 3995.00; within 30 days of receiving my acceptance notice I will make a non-refundable deposit as my first tuition payment of $1,000. The remaining tuition balance of $2995 will be paid monthly in 10 monthly payments of $299.40 via automatic withdrawals from your bank or credit card or may be paid in full. If payment is made in full there will be a 5% discount offered.

By providing my signature, my typed legal name, below I am agreeing to the terms and conditions stated above. I confirm that the information provided in this application is complete, accurate, and honest to the best of my knowledge.

This program requires a minimum of 8 participants in order to run. If for any reason the program is unable to run due to unforseen circumatances you wil be notified and your initial deposit will be refunded to you within 30 days.

Required

Once this Application has been completed and sent back to us, we will contact you by email to schedule a Zoom meeting to answer any questions you may have and complete your enrollment.

I'm available by Zoom

I'm not available by Zoom, please offer me an alternative meeting method.

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