Full Name *

Email *

Phone *

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Instagram Handle *

City, Country of Residence *

Are you a certified breathwork facilitator? (Our Level II Training is only for certified facilitators) *

Yes

No

Who did you certify with? *

When did you complete your certification? *

Do you have any prior training in trauma-informed facilitation? *

Very confident

Somewhat confident

Not yet confident

How often do you currently facilitate breathwork sessions? *

Weekly

Monthly

Occasionally

I haven’t facilitated yet

What type(s) of breathwork do you currently facilitate (if any)? *

How familiar are you with somatic healing practices? *

Very experienced – I incorporate somatic work into my facilitation regularly.

Some experience – I have some understanding and have applied it in my work.

Minimal experience – I’m aware of it but have not deeply explored it.

No experience – I am new to somatic healing but eager to learn.

What are your biggest challenges as a facilitator right now? *

What is your intention for taking this Level II training? *

Based on your application, we’d love to move forward. Please take a moment to speak directly to Jamie. We’re excited for the possibility to have you join us in Bali!

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