First Name

Last Name

Email *

Phone *

Address

Street Address *

City *

State *

Country *

Postal code *

Occupation / Job

Gender *

Female

Male

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What is drawing you or inspiring you to apply to Courting Your Medicine? *

What makes this the right time in your life to enroll in this program? *

Please list and briefly describe the psychological work, personal development, spiritual work, soul-oriented, or nature-based work you've previously experienced. *

What do you already know about your "soul work" or your unique offering to the world? How are you currently offering your gifts? (teaching, healing, writing, guiding, as a chiropractor, etc.) *

Does anything about this program feel edgy to you? *

What do you imagine you will have to let go of to become who you really are? *

What do you imagine your life could look like if you embodied your deepest gifts? *

Please describe any needs or conditions that may impact your participation and for which you would like support or accommodations. *

Are you interested in camping on the training site land and in need of additional information? *

How did you hear about Somatic Nature Therapy Institute and/or the program you selected? *

Program year you would like to attend: *

How did you find us? *