MEN'S APPRENTICESHIP

AUSTIN, TX

10.21 - 11.20

Last Name *

Date of birth

First Name *

Email *

Mailing Address* *

Phone *

Emergency Medical Contact (Name & Phone) *

What is your intention for joining the Tobacco Apprenticeship? *

What is the biggest challenge you are currently facing in your life? *

Day to day, how's your inner emotional universe? Calm, stormy, rollercoaster, numb, etc. *

Are you currently working through any physical maladies? Bone breaks, surgeries, autoimmune disorders, gut issues, etc? *

Do you currently take any medications? If so, please list: *

Do you regularly work with any herbal medicines, supplements or plant medicines? Please list. *

Do you have any allergies? *

Are you pregnant or breastfeeding?

What are your sensitivities and known triggers? Physical, emotional, social *

Briefly summarize your history & experience with shamanic plant medicine. *

Have you worked with shamanic tobacco before? In what forms and with who? *

What is your most significant critique or suspicion with shamanic culture and the plant medicine community? *

Please describe your current understanding of shamanic tobacco, as fully and thoroughly as you can. *

If there is any fear present about this apprenticeship, can you name it? *

What's the biggest edge you've had to overcome to do this apprenticeship? *

What most excites you about joining the Tobacco Apprenticeship with our community? *

Anything else you would like to add or note for our facilitation team to consider? *