Application for Follow Your Longing Into the West
April 24–25, 2021

This program includes experiences that access dimensions of yourself that are underneath your ordinary consciousness. Out of respect and care, we want the program to be a good match for you and the other participants. We hold your responses in confidentiality.
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Name *
Email Address *
Phone Number *
What draws you to this program? *
Have you worked with self-healing and wholing modalities such as The Wild Mind material? *
Have you experienced trauma in your past? If so, do you feel that you have sufficient healing resources to draw upon should your participation in the program activate past challenges? *
What practices or resources do you use for your emotional support? *
Are you currently taking any prescription or over-the-counter medications or recreational drugs? If so, what are they and what are they for? *
Is there anything else you want us to know about yourself and your interest in this Northwest Soulquest program?
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