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Magi Ancestral Supplements Engagement Application for Practitioners
Please complete this intake form to be considered for our affiliate program.
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* Indicates required question
Email
*
Your email
What is your name?
*
Your answer
What is your business name?
Your answer
If you are applying to be an affiliate as a practitioner, which one of the following presents your practice:
1) Psychedelic Psychotherapy
2) Psychedelic Sitter/Facilitator
3) Integration Session Facilitator
4) Shamanic Practitioner
5) EMDR Psychotherapist
6) Psychoanalyst
7) Meditation Instructor
8) Mindfulness Coach
9) Breathwork Practitioner
10) Yoga Instructor
11) Leadership & Self-Development Instructor
12) Life Coach
13) Psychiatrist
Other:
What training, degree, or experience do you hold related to your practice?
*
Your answer
Which city are you based at?
*
Your answer
Please enter your website and/or social media handles:
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Your answer
Tell us about your background:
*
Your answer
What makes Magi Ancestral Supplements products a good fit for your practice?
*
Your answer
Which products are an especially good fit for you?
*
Stard Deep Meditation Aid
Mang Lucid Dream Aid
Ushta Mood Boost Supplement
Haurvatat Deep Sleep Aid
Ameretat Neurogenesis Supplement
Haoma Revelation Aid
Required
Why?
*
Your answer
Would you like to test our products in the format of 30% discounted trial packs? (Note: Haoma Revelation Aid is not available in trial size)
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Yes - Please register my email for discounted access
Maybe - I need more information before I commit to try
No - Not at this stage
Other:
How many clients per month do you currently have?
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Your answer
Would you be interested to help our protocols development trials with your clients?
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Yes
No
Maybe
Would you be interested to participate in our research and trials?
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Yes
No
Maybe
What support do you need from us to be successful?
Your answer
Would you be interested in exploring Magi's affiliate program if we find alignments?
*
Yes
No
Would you be interested in any of these collaborations?
*
Work with us as a guest practitioner on content creation (articles, podcasts, webinars, guest speaker,etc)
Work with us as local event host (supplemented mindfulness activations)
Be our products ambassador (in case of mutual alignment and test of efficacy)
Other:
Required
Other questions/comments?
Your answer
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