1 Year Facilitator Training Application

F.I.V.E.
5-MeO-DMT Information & Vital Education

1 Year Facilitator Training Application Form
Note:

Please fill in your name and email in form fields, otherwise we will not be able to contact you. For information such as prices, dates and more, scroll to the bottom PDF.
All information disclosed within this form is confidential and will not be shared with anyone outside of F.I.V.E.

Please do not leave any fields blank. If you can not fill out a field, simply write N/A.
Date

Month Day Year
Date
Name

First Name Last Name
Email
example@example.com
Location

City Country
Website/ Links

Website URL Linkden URL
Social Links

Instagram URL Facebook URL
Experiential Information

This section helps us understand your current personal relationship and understanding of 5-MeO-DMT.
When was your first experience with 5-MeO-DMT?
How many times have you sat with 5-MeO-DMT?
How many different 5-MeO-DMT facilitators have you sat with?
Describe what is your personal relationship with 5-MeO-DMT like?
Why do you want to serve 5-MeO-DMT?
F.I.V.E. does not support work in countries where 5-MeO-DMT is illegal. Do you agree to serve only in countries where not illegal?

Yes No
Do you currently serve any other medicines?
Have you ever been a space holder or assistant for 5-MeO-DMT ceremonies that you have not personally sat in?
Please list any credentials, courses or modalities that you possess. (Examples are psychology degrees, integration certifications, breath work, meditation, etc..)
Have you ever been in a teaching or facilitating role?
Have you taken time to focus on your own healing before attempting to start supporting others in their healing journeys? Please explain.
What is your experience with other psychedelics and plant medicines?
What is your relationship like with self inquiry? How do you keep yourself accountable? What practices do you use? Do you have any teachers or mentors to support you in this? Please explain.
Have you ever taken a 5-MeO-DMT training course before? If so, please describe it.
Are you aware that the position as a facilitator, means to put the participant first? Please explain what this means to you.
Serving this medicine is a great responsibility and many facilitators chose to make their offering all about themselves and their ego, are you committed to continually growing, learning, and deepening your understanding of how to be of service to your participants?
Community References

Please list 3 references. A minimum of two references must be from a facilitator who has served you in the past, while the third can be a teacher, mentor or guide on your path. References will be contacted.
Facilitator #1 Name

First Name Last Name
Facilitator #1 Email
example@example.com
Facilitator #1 Phone Number
Please enter a valid phone number.
Please describe your relationship with this facilitator, how many times you have sat with them and what your experience with them was like.
Facilitator #2 Name

First Name Last Name
Facilitator #2 Email
example@example.com
Facilitator #2 Phone Number
Please enter a valid phone number.
Please describe your relationship with this facilitator, how many times you have sat with them and what your experience with them was like.
Reference # 3 Name (Teacher, Guide, Mentor, Facilitator..)

First Name Last Name
Reference #3 Email
example@example.com
Reference #3 Phone Number
Please enter a valid phone number.
Please describe your relationship with this reference, how many times you have sat with them and what your experience with them was like.
I certify that my answers are true and complete to the best of my knowledge. If this application leads to my acceptance in this program, I understand that false or misleading information in my application or interview may result in my release.

Yes No
Thank you for your submission to join F.I.V.E's 1 Year Facilitator Training!

Selected applicants will be contacted through email by F.I.V.E to continue the application process with a video interview.

Applicants will be chosen no earlier than August 1st and no later than October 1st.
For more details about program including dates, cost and more, scroll down on this PDF attachment. (It may take a moment to load.)
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F.I.V.E.

5-MeO-DMT Information & Vital Education

Note:

Experiential Information

Community References