Illuminate Application
Questionaire for the potential to join Simon for The Five Week Online Illuminate Immersion. You are not being judged by your answers, almost everyone is able to join this experience. However there is only space for 11 male bodies & 12 female bodies. The selection process is necessary for the integrity of the container I am cultivating.
Sign in to Google to save your progress. Learn more
Email *
Your Full Name
*
Illuminate Application
Please watch If you are coming direct to this application form.
You can read and watch more on this web link: Simon Transparently
Program with fixed dates and time zones for you to check:

All weekday sessions will be approx. 2.5 hrs.
Time Zones: 18:30 UK | 19:30 CET | 10:30 PST | 15:00 EST

All weekend sessions will be approx 4 hrs:
Time Zones: 14:00 UK | 15:00 CET | 6:00 PST | 9:00 EST

Thur 1st Dec: Opening Heart Circle
Fri 2nd Dec: Introduction to Joe Dispenza meditations. (morning session 8am UK optional)
Sat 3rd Dec: Pain Body to Play Buddy
Mon 5th Dec: Emotional Release Initiation
Sat 10th Dec: Awaken Your Pleasure Potential
Mon 12th Dec: Heart Circle Presence session.
Sat 17th Dec: Three Circles Ritual

Then:
Mon 19th Dec: Osho Dynamic Meditation
Thur 22nd Dec: Laughter, Tears, Silence (Marc)
Tues 27th Dec: Heart Circle Presence session.
Thur 29th Dec: Lila Divine Play – Enlighten Up
Mon 2nd Jan: Orgasmic Manifesting

Closing Ceremony:
Sat 7th Jan: Heart Circle – A New Vision | The Path Ahead.

In between the above fixed dates you will have daily practices and meditations. There will be time for integration, rest and space for reflection.

Age and Star Sign
*
Do you know your Human Design? (not compulsory) *
Required
And/or your Gene Keys profile? (not compulsory)
*
Required
Why do you want to join Illuminate? Share in detail...
 *
You will need your own comfortable space with the safety & ability to explore sound through active meditations, emotional release and self-pleasure.

You will also need a computer and good wifi connection (not mobile phone). A computer will empower your experience and be far better for drop out rooms and seeing the whole group on the screen.
*
Required
How is your physical health / fitness? Do you have any medical conditions or taking medication? I shall be using dynamic meditations, intentional breathwork and other vigorous practices during this immersion. You are able to go at your own pace and level but it's important for me to know if you have any contraindications of any kind; heart conditions, high blood pressure, diabetes, osteoporosis, asthma or other please state.
 *
Are you experiencing depression and taking any antidepressants or antipsychotics?
*
Do you drink alcohol, smoke cigarettes, weed or take any other substances? Such as Cocaine, Ecstacy, LSD, Mushrooms, Plant Medicine? Please list and also in what relation you take them. i.e. ceremonially, recreationally, habitually or clinically.
*
What are your self-loving practices or personal practices (as you may not call them self-love) at the moment and how much time do you spend on them daily / weekly? *
What is your relationship to masturbation? Do you masturbate or self-pleasure? (they are different as you will learn during the immersion) Do you use porn for visual stimulation? If so, how often?

Please share what feels comfortable in this moment, in the knowing that this form is confidential.

We shall be implementing self-pleasure practices during this immersion and if you do have a sex addiction of any kind, these practices will support the healing and balance of these behaviours. *
What survival emotions do you struggle with most in your life? (survival emotions are the more dense, sometimes labeled negative emotions) *

In which areas of your life are you experiencing lack?

 *
Required
What changes in your life would you like to implement in 2023? This is in relation to all areas / your physical, financial, mental, emotional, and spiritual.
*
What project or vision would you like to manifest into form in 2023?

Dream big here, no limits, just let your imagination run free, no need to consider the blocks of whether you have the money or resources, just share what ignites the fire in your heart. *
Living In The Gift:

The initial gift investment of €478.00 is not only to recieve and experience this five week immersion, it's also a significent statement of your commitment to YOU.

You are welcome and invited to increase this amount after the five weeks based on your experience.

If for the unlikely reason you find no value from the experience, you are welcome to communicate to me and we shall find a loving solution that serves us both.

Please write below what option serves you:

* Very happy to gift the €478

* I would love to pay 2 instalments of €239

* If you are currently finding it more difficult to circulate money in your life but really want to join please state what alternative amount below.

* I have crypto currencies I'd like to offer.

The invitation of the gift is to tap into the your abundance. Love finds a way


 *
Are you happy for me to add your email to my mailing list, I share sporadic, sometimes weekly, fortnightly content, podcasts, events, inspiration, LOVE.
*
Required
Anything else you feel relevant to share here, please do so here...
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms