Shamanic Apprenticeship Intake Form
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.
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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: *
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: *
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.  
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