Alchemical Leadership 2019 Application
Please complete the full form to apply for the Fall 2019 Alchemical Leadership cohort.
Full name *
Email address *
Phone *
Mailing address *
Preferred pronouns *
E.g. She/Her, He/Him, They/Their
How do you self identify across various identity vectors? *
As we aim to assemble a diverse group, we wish to know more about the various facets of your identity (including standard aspects like age, race, gender, sexual orientation, nationality, etc, as well as other aspects of your identity that feel core and inform how you show up)
How did you hear about Alchemical Leadership? *
If not from Larissa, please share who referred you.
Current organization, role, and tenure *
Why do you feel called to participate in Alchemical Leadership? *
What are your main desires and challenges right now? *
What are the core routines that currently fuel your creativity and performance?
How would you rank your sense of proficiency in each of the 5 core areas of the course? *
Low
Medium
High
Personal Wellbeing
Relationship & Intimacy
Org Transformation
Living Community
Ceremony
Please elaborate on any of your responses to the above question (optional)
What is your sense of the possible area(s) of expertise you may want to share via a learning experience for the group to support the Alchemical Leadership curriculum? *
You can refer to the curriculum overview on the website for detail on the course focus areas.
Are you physically fit enough to hike with an approximately 30 pound backpack for several miles across low elevation gain? *
Do you have any health conditions that could prevent you from participating in the Immersion and Quest? *
If so, please explain. *Note* We reserve the right to require a medical examination of any potential participant at the participant's expense and to reject any potential participant for medical reasons at any time prior to or during a program.
Preferred investment & accommodation type at Community Immersion *
Please select your preferred investment and accommodation type for the Community Immersion. (*Since there are a limited number of each accommodation type, we will do our best to fulfill your preference and will communicate with you prior to accommodation assignment.)
Other possible investment & accommodation type at Community Immersion
If you are open to more than one tier of investment and accommodation type, please indicate the additional options here.
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