Elder Wisdom - Application
** PLEASE NOTE THE START DATE CHANGE**


Program Timing: 5 months - March 15th to July 30th, 2024

Fridays 10:00am -12:30pm (Pacific time)
Mar 15, April 19, May 17, June 21, July 19

Tuesdays 4:00-5:30om (Pacific time)
Mar 26, April 30, May 28, July 2 (witness ritual), July 30 (closing ceremony)


Cost: $325/month USD, ($1625 total) with a few financial access spots available.

* Please note, we can only accept USD currency at this time, and payments will be automatically billed monthly to your chosen pay method (Credit care, Debit card, Paypal, Apple Pay, Google Pay all accepted). Thank you for your understanding.


After we receive your application, we will  be in touch with you for next steps. Your spot is confirmed when your first monthly payment is received. Thank you!

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Email *
Name
 *
Pronouns *
Generally, what is your ancestral background? That is ok if you don't have full understanding of who and where your people are from. Share what you can.
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Please provide a brief description of why you are interested in this program. What are your hopes in participating? Thank you.
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Have we worked together before? Please check which apply to you.
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Required
Please provide a brief description of any experience you have with somatic/embodied practices and awareness. We welcome both professional training, educational programs, and/or personal experiences and practices.
*
Please provide a brief description of any experience you have with spirit work/relating, including with your ancestors in spirit. We welcome hearing about training, courses and personal experiences and practices you feel are relevant.
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Please provide a brief description of any experience you have with cultural healing, liberation frameworks or social justice/decolonizing practices. We welcome both training programs and self-study/group practice etc.
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Please provide a brief description of the other support and resources you have outside of this program offering, should you need it.
 *
Do you have any accessibility or learning needs that you would like us to be aware of?
By sending in your application you are agreeing that you are willing and able to attend the majority of the program dates, to participate in smaller group breakouts when invited, and to have your camera on (unless otherwise invited for certain exercises, or unless you have an accessibility request).
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Required
Please indicate which pricing tier you are able to pay (please note, payment is in USD only)
Feel free to refer to this 'financial access chart' to help assess where you are on this sliding scale. Thank you.
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We have a limited number of Reduced and Sponsored spots offered on the honor system. If you apply for either, we ask that you share 1-2 sentences about how/why these tiers might support your participation in this offering. Thank you.
I understand that due to the small group nature of this program, there are no refunds on monthly payments already made.

If an unforeseen circumstance arises that I cannot participate for the full 6 months, I understand that my future monthly payments will be cancelled, but that any monthly payments already made are non-refundable.

*
Required
Consent and Liability Waiver Agreement:

I understand that this program offered by Tamira Cousett and Shauna Janz is for educational and therapeutic purposes. It is not therapy, although it will likely have therapeutic benefit. I understand I might experience some emotional, mental, spiritual or physical learning edges or stress (growing pains) and that participating in this program may facilitate personal healing as an outcome of my participation. I understand that I am encouraged to have additional resources outside of this program setting should I need further support.

I agree willingly to release from any claim Tamira Cousett and Shauna Janz, any program supporters and program participants from responsibility for any of the possible learning edges or stress responses aforementioned.
*
Is there anything else you would like us to know about you, your application or your interest in this program? Thank you.
A copy of your responses will be emailed to the address you provided.
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