Thank you for taking the time to apply to the 
2017 Wild Craft Uprising program.

We suggest typing your answers in a separate document and then copying and pasting to this form.  The worldwide web (both literally and phenomenologically) has been known to interfere with successful application submission. Though we're using the best form submission technology available, backing up your answers may be wise.
First Name *

Last Name *

Phone Number *

Address: Number & Street *

Address: Apartment #, Suite #, etc

City *

State *

Postal / Zip Code *

Country *

Birthdate *

How did you learn about the Wild Craft Uprising program? *

What are your hopes and expectations for both the program experience and lasting impact in your life? *

What concerns or fears do you have about the program? *

Please describe your prior experience with Earth-based healing. *

What parts of yourself and your life are calling for your attention, love, and nourishment? *

With the present economy, do you foresee financial challenges that could affect your participation with the Wild Craft Uprising program? *

Do you have any allergies, food sensitivities, or food preferences? *

The Wild Craft Uprising program will often be emotionally intense. Integral to our experiential process work is contacting and clearing the imprints of inherited trauma. To keep a safe container for all, we ask participants to evaluate their capacity to feel and release strong emotions. If you have a serious medical, substance, or emotional condition or are living through challenging or unstable life circumstances, we respectfully request that you disclose this so we can effectively evaluate whether the program is suitable for you. *

Thank you for applying for the program!  We will review your application and be in touch with you within the week.
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