ISTA Practitioner Training Application
Event Timing: October 22 - 30, 2021
Event Address: 391 Herrington Hill Rd, Greenwich, NY 12834
Contact Cell/WhatsApp: 1 (413) 204-0314 or email:

All information that you provide on this form is totally confidential. Information provided will assist with the processing of your application and for our Group Facilitators to work with you more effectively should you be accepted into the training. This information will only be seen by the group training facilitators and the group organizer. Some of your application information may be shared with your Level 1 and/or 2 lead faculty and feedback requested to support your application consideration. Thank you for taking the time to answer all areas. Please read your application. Submission indicates your acceptance of, and agreement to, the following statement:
Name *
Date of Birth *
Gender *
Nationality *
Email *
Phone Number *
Skype/WhatsApp Account *
Mailing Address *
Emergency Contact Information *
Current Profession *
Dietary restrictions *
How did you hear about this training? *
Please give a summary of your meditation and/or Personal Development experience *
Please outline your experience of Tantra / Sacred Sexuality *
Are you currently working as a Sexuality Practitioner? *
If so, please describe your Practitioner work
If you are doing any work in the fields of Counseling, Bodywork, Coaching or Sexual Healing, please describe. *
Have you completed ISTA Level 1 & 2? *
Where & When did you attend ISTA Level 1 & 2? Please also specify the Lead Facilitators. *
What is your personal motivation for becoming a Sexuality Practitioner? *
Please list any previous Sexuality Practitioner trainings you have attended. *
Please describe any previous Sacred Sexuality Sessions you've received in either Individual or Group settings. Please include any experiences of Sexual Healing. *
Do you have any Medical Conditions that may impede your capacity to participate in this course? Are you currently on any Medication? If so, please specify. *
What personal traits or gifts do you bring which will enrich the Field in this training? *
Is there anything else you would like to share with us?
Please choose Room Assignment and Investment Price *
"I understand that the group, session, and training processes with ISTA focus on development of consciousness and individual responsibility. Therefore, I understand that I am fully responsible for the nature of my experience and I am invited to refrain from doing anything contrary to my values and in opposition to my consciousness. As an adult, I agree to be responsible and respectful in my interactions with others. I will use clear direct verbal communications and if I am not comfortable with something, I will express my concerns clearly and directly to the facilitators and organizer. I agree to monitor my participation and not exceed my own physical and emotional limits and I assume all risk for my condition in this workshop. I acknowledge that I assume all risk from any consequences due to any pre-existing physical or psychological conditions that I have." *
“I understand and recognize that some of the content in the ISTA trainings and exercises is of spiritual and sexual nature. I agree that my interactions and experiences during the group, training or outside of session processes stays under my control, and that the ISTA teachers, session givers and organizers are not in any way held responsible for my actions, experiences, or the actions of others. I agree to act responsibly in regards to my previously existing relationships or agreements and to seek advice from a facilitator during the training should I feel at any time uncomfortable with any of the exercises or interactions within the group. In submitting this application, I agree that I have read & understood the above text/information." *
I understand and agree that I chose to attend and participate in a training where the 1 to 2 meter social distancing guidelines can not be guaranteed by ISTA, the Faculty, organizer or venue. I will be responsible for my own health and well-being, utilizing whatever safety measures I feel are appropriate for myself and others. Furthermore I will disclose to Faculty if I am feeling any symptoms of Covid or any other possible illness, such as a fever, cough, etc. knowing that I may be asked to not participate in training. *
I understand that upon acceptance into the PT I will be required to make a non - refundable $500 deposit and pay the reminding balance prior to 30 days of beginning of the Training. *
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