Yoni Temple Program Application

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**Please note that filling out this application does not automatically enroll you in the program. These questions are intended for us to get to know you, understand where you are at on your journey, and determine whether or not this program is an aligned fit for you.

Please treat this application as though it were an initiation into a sacred ceremony. You might even light a candle or burn some incense. Take your time filling this out, share from your heart, and please be as specific and descriptive in your responses as possible.

Once you have completed this form, we will be in contact with you shortly to arrange a phone call to connect with you 1 on 1 and talk about the next steps for enrollment.

Thank you!

The Yoni Temple Sisters
Juilaila, Sam, & Lilikoi

Email *

If you have an Instagram, please submit your handle name!

First & Last Name *

Phone Number *

What are your preferred gender pronouns? *

Please share about why you feel drawn to this specific program. *

What has your journey been like in relationship with your womb and your body? *

How do you desire your relationship to your womb and your body to be, if different than above? *

What other programs, courses, workshops, trainings, coaches, or other resources have you tried to address these specific concerns, if any? How effective/supportive have these programs been for your specific needs? Please be specific. You can write "none" if this will be your first! (we accept womxn with all levels of experience in this work, this is just to get a sense of where you're at in your journey) *

Please share your intention for embarking on this journey. Imagine yourself at the end of this program and paint a picture of your *most ideal* scenario - no limitations! What's changed? How do you believe this program will benefit your life? Really feel and see the vision and share with us below.... *

We want to make sure you are aware of the financial investment listed on our website and are prepared to make this investment. Where are you at with this? *

So excited! Feeling so abundant and ready to pay in full!

I am opening to receive more abundance and wealth. For now can do monthly payments

I am financially struggling right now but I am resourceful and can find a way to make it work

Required

On a scale of 1-10, how devoted are you to embodying this work and creating the desired shifts in your being and/or in your life? *

I am not devoted to making this happen at all.

100% I am ready and willing to do whatever it takes. I understand I am the creatress of my life and this is what I choose for my reality!

Send me a copy of my responses.

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