The IMMERSION LABS Participant Application
Only serious inquiries for participation will be approved for selection.
SECTION 1: WHO ARE YOU?
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number (SMS-capable)
*
Please enter a valid phone number.
Format: (000) 000-0000.
City / State (or Country)
*
SECTION 2: WHY THIS EXPERIENCE?
What brought you here—right now?
*
One paragraph. No polishing. What’s shifting or breaking?
Which statement feels closest to your current reality?
*
I’m successful, but something is off
I’m repeating a cycle I’m done tolerating
I’ve done inner work—but it hasn’t fully integrated
I’m rebuilding after a collapse or major transition
I feel a pull toward something more precise and embodied
SECTION 3: WHEN ARE YOU READY?
This Immersion Labs are intimate, embodied, and disruptive. Are you open to being challenged—physically, emotionally, and mentally?
*
Yes
Yes, with awareness of my limits
Not right now
SECTION 4: HOW COMMITTED ARE YOU?
If accepted, are you prepared to invest time, attention, and financial resources into this experience?
*
Yes
Possibly
No
Are you open to a brief follow-up conversation before final selection?
*
Yes
No
SECTION 5: WHAT DO EXPECT FROM THIS?
(The quiet tell.)
In one sentence: what do you want to leave behind?
*
ARE YOU INTERESTED IN HOSTING LABS IN YOUR CITY?
Could your area benefit from this type of experience?
Please Select
Yes
No
Not Sure
Submit Application
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