Personal Information

First Name *

Last Name *

Email *

Phone *

LinkedIn Profile *

Location (City, State, Country)

How did you hear about Portrayals XR? *

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

Professional Background

Which category best describes your expertise? (Select all that apply) *

Other

Please briefly summarize your professional background and current role. *

What unique perspective, experience, or expertise would you bring to the Portrayals XR Advisory Board? *

Values & Alignment

Have you had personal or professional experience with emotional healing, trauma work, or immersive wellness? If so, please share what has impacted you most. *

Why are you drawn to the mission of Portrayals XR? *

In your own words, how do you define transformational healing? *

Are there specific populations, causes, or innovations you are particularly passionate about? *

What networks or connections do you have that could be beneficial to our organization? *

Availability & Expectations

Our advisory board meets every two weeks and may require 3–5 hours/month (slightly more during the early stages). Are you able to commit to this level of involvement? *

Would you be open to additional opportunities to support the mission (e.g., networking, speaking, collaborating on pilots)? *

Professional Background & Expertise

Have you previously served on any advisory boards?

If so, what was your role and impact?

Conflicts, Ethics & Legal

Do you currently serve on any other boards or advisory roles? Could any present a conflict of interest?

Are you affiliated with any companies or investors that overlap with our market or competitor space?

Have you ever been involved in a legal dispute or regulatory issue as part of a board or executive role? *

Final Thoughts

Tell us one professional strength you bring to the table and one area where you know you’re still learning. *

What excites you most about the future of mental health, immersive healing, or consciousness work? *

Is there anything else you'd like us to know about you? What makes you unique? *