Breathwork Certification Application Form

Meir Kay Breathwork Certification Form

All that is shared here is confidential.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Age
Where do you live?
Do you have any prior experience with breathwork, meditation, or similar practices? If yes, please describe.
Have you attended any workshops or retreats led by Meir Kay or similar programs?
What personal or professional goals do you hope to achieve through this program?
Have you worked on your personal growth or healing journey before? If yes, please describe.
Do you have any physical or mental health conditions that could affect your participation in the program? If yes, please explain.
The Program consists of a 3 day in-person retreat in South Florida followed by a 9 week online program which consists of weekly zoom calls and homework. Are you ready to commit time, energy and monetary investment to reach your goal?
Which of the following cohorts would you be interested in?
If the retreat dates above work for you, which date/time would work for you for the weekly calls?
How did you hear about this workshop?

Other
Is there anything else you’d like us to know about you?
Should be Empty:

Meir Kay Breathwork Certification Form