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Radically Loved Mentorship Program
Event Timing:
This Program Begins Monday August 1st 2017- Ends December 1st, 2017
Event Address: Online & Portland, Oregon
Contact us at
Email address
First/Last Name
Best Phone# To Reach You:
Age Group:
Emergency Contact Name:
Emergency Contact Phone Number
How Did You Hear About This Program?
Name of 200 hour training school and graduation date:
What do you feel your main strengths as a teacher are?
What areas of your teaching would you most like to work on?
Why would you be drawn to Rosie Acosta as a mentor?
Do you have a regular daily practice? If so please describe it:
Please tell us about your health: injuries, conditions, illnesses or anything else that might impact you, your practice and preparation to teach:
So how is your mindset lately?
I understand that one-on-one time with Rosie as my mentor will be done via Skype (in person when possible) 4 Sessions total
I understand that doing my homework, individual practice, and working on my own is a big requirement for the success of this program.
I understand that I will be assigned a mentor approved by Rosie to work with in person
What are your expectations for this apprenticeship?
What do you hope to learn/work on?
I acknowledge that this program will benefit me most by doing the work, this requires SELF-MOTIVATION and WILL, ACTION + KNOWLEDGE.
I understand due to my mentor schedule that the in person meeting locations will be announced every month, and will do my best to make up sessions as needed.
You will be able to schedule up to 2 makeup sessions if missed included in the cost of tuition. Above that, the rate will be $100 per hour missed.
What Will Be Your Word of Intention For This Program?
I acknowledge the $1500 tuition fee for the mentorship program and that all payments are non-refundable. I understand that I will have to pay prior to the beginning of this training unless arranged otherwise.
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