Moxie School - Immerse Interest Form

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Moxie School - Immerse Interest Form

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First Name *

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Last Name *

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Email *

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Phone Number *

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Please describe your interest in attending an Immerse Retreat. *

Your answer

Please describe your current experience with expanded states to date: *

Your answer

Please indicate your profession and any way you hope to use psychedelic facilitation in your work: *

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