Work With Aurora - Application & Inquiry
Apply to Work With Aurora by completing this Application + Inquiry Form.Your responses help us understand where you’re at, what you’re seeking, and which offering (one-off, mentorship, or a custom pathway) is the most aligned next step.
Personal Information
Tell us about yourself.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
WhatsApp Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Time Zone
*
Please Select
UTC-12:00
UTC-11:00
UTC-10:00
UTC-09:00
UTC-08:00
UTC-07:00
UTC-06:00
UTC-05:00
UTC-04:00
UTC-03:00
UTC-02:00
UTC-01:00
UTC+00:00
UTC+01:00
UTC+02:00
UTC+03:00
UTC+04:00
UTC+05:00
UTC+06:00
UTC+07:00
UTC+08:00
UTC+09:00
UTC+10:00
UTC+11:00
UTC+12:00
Other
Date of Birth
*
-
Month
-
Day
Year
Date
Time of Birth
Hour Minutes
AM
PM
AM/PM Option
Place of Birth (Address, City, Postcode, Country)
*
Intentions and Goals
Share your intentions and what you hope to achieve.
What are you seeking right now? (choose one)
*
Please Select
1. A one-off session (clarity / clearing / guidance)
2. Ongoing support (mentorship / deeper restoration / 3 months+)
3. Medicine preparation & integration support (before/after ceremony work)
4. A group container / retreat (interest / waitlist)
5. I’m not sure - I want Aurora to advise the best next step
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3-Month Mentorship Applicants Only - Readiness, Agreements & Logistics
The following questions apply only to the 3-month mentorship/container.If you’re requesting a one-off session or another pathway, you won’t be shown this section.
WhatsApp Communication Agreement
Support via WhatsApp is available only for the 3-month Mentorship container. Messages are responded to within 48 business hours (Monday–Friday). WhatsApp is for integration support and check-ins - not crisis care.
When it comes to growth or change, which pattern is most true for you right now?
Please Select
I tend to rush and override my body
I tend to avoid, delay, or stall
I can move steadily with support
I’m not sure yet
WhatsApp Communication Agreement
I understand and agree
I do not agree
Financial Readiness & Commitment
Please Select
I am ready and able to pay in full
I am ready and prefer a structured payment plan
I am financially ready but would like to discuss options
I am not financially ready at this time
I am unsure
Mentorship Scope & Responsibility Agreement
This is a spiritual mentorship container focused on nervous system regulation, integration, and personal responsibility. It is not therapy, psychiatric treatment, crisis care, or medical advice. You remain responsible for your physical and mental health and for seeking licensed support when needed.
Mentorship Scope & Responsibility Agreement
I understand and agree
I do not agree
Direct Communication Agreement
If something feels misaligned, uncomfortable, or unclear within the container, I commit to communicating directly rather than withdrawing, ghosting, or building silent resentment.
Direct Communication Agreement
Yes - I am willing to communicate directly
I’m unsure
No
Are you willing to take personal responsibility for your growth and healing during this program?
*
Yes, I am willing and ready.
No, I am not ready at this time.
On a scale of 1 (not ready) to 10 (fully ready), how ready do you feel to commit to this mentorship?
*
Not ready
1
2
3
4
5
6
7
8
9
Fully ready
10
1 is Not ready, 10 is Fully ready
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Why are you feeling called to this work at this time?
*
What would make this a clear YES and worth it in 90 days?
*
What is the “fire alarm” in your life you can’t ignore anymore?
*
What are you willing to change, even if it’s uncomfortable?
*
Current State
Let us know about your current emotional and nervous system state.
Which best describes your current season?
Deepening an existing spiritual path
Recalibrating after feeling drained/out of alignment
Both
Major Life transition
Seeking Purpose/clarity
Other
What are you currently experiencing?
Sleep issues
Anxiety / nervous system activation
Emotional heaviness / grief
Energetic heaviness
Overwhelm
Feeling porous / absorbing others
Brain fog
Disconnection / numbness
Spiritual sensitivity increasing
Unusual dreams / visions
Difficulty grounding
Physical symptoms
Other
Describe your experience day to day
*
What have you tried so far? What helped or didn’t?
*
What do you sense might be at the root?
On a scale of 1 (very dysregulated) to 10 (very regulated), how would you rate your nervous system currently?
*
Very dysregulated
1
2
3
4
5
6
7
8
9
Very regulated
10
1 is Very dysregulated, 10 is Very regulated
Lifestyle & Wellbeing
Share your current lifestyle and wellbeing habits.
SLEEP
Average bedtime
Hour Minutes
AM
PM
AM/PM Option
Average wake time
Hour Minutes
AM
PM
AM/PM Option
Average hours of sleep
Hour Minutes
AM
PM
AM/PM Option
How would you rate your sleep quality?
*
Poor
1
2
3
4
5
6
7
8
9
Excellent
10
1 is Poor, 10 is Excellent
Stimulation
Caffeine intake (type + amount)
Latest caffeine time
I don’t consume caffeine
Before 10:00am
10:00am – 12:00pm
12:00pm – 3:00pm
After 3:00pm
After 6:00pm
Screen Time after 9pm?
Yes
No
Conditional: Screen Time Duration Per Day
Exercise
Do you exercise
Yes
No
How often do you exercise?
*
Please Select
Daily
Several times a week
Once a week
Rarely
Never
Conditional: What exercise do you do?
What does your body feel like most days?
NUTRITION / SUGAR / WATER
Water intake per day
Less than 0.5 L (0–2 cups)
0.5–1 L (2–4 cups)
1–1.5 L (4–6 cups)
1.5–2 L (6–8 cups)
2–3 L (8–12 cups)
3+ L (12+ cups)
Not sure / varies day to day
Add electrolytes/minerals?
Please Select
Never
Sometimes
Often
Daily
Urine color
Please Select
Clear
Pale
Dark
Varies
Symptoms improve with water?
Please Select
Yes
No
Unsure
Describe your diet
Skip Meals
Yes
No
Protein with first meal?
Please Select
Yes
No
Not Sure
Late-night snacking
Please Select
Yes
No
Sometimes
Often
Most Nights
How would you describe your nutrition?
*
Please Select
Very healthy
Mostly healthy
Moderate
Needs improvement
Added sugar frequency
Please Select
Never
Multiple times a day
Energy crashes after eating
Please Select
Never
Sometimes
Often
Cravings strongest
Please Select
Morning
Afternoon
Evening
Late night
Sugary drinks
Please Select
Never
Daily
Sometimes
Stress affects eating
Please Select
Eat more
Eat less
Irregular
No change
Metabolic/thyroid issues
Yes
No
Fast food frequency
Please Select
Never
Rarely
Once a week
5x week
Ultra-processed food
Please Select
Never
Sometimes
Often
Daily
Eat out vs cook
Please Select
Mostly home
Mixed
Mostly out
Biggest barrier
Please Select
Time
Money
Skills
Cravings
Emotional
Travel
Other
Alcohol
Please Select
I don’t drink alcohol
Less than once per month
1–2 times per month
Once per week
2–3 times per week
4–5 times per week
Daily or almost daily
Nicotine
Please Select
No
Yes - occasionally (1–3x/month)
Yes - weekly (1–6x/week)
Yes - daily
Yes - multiple times per day
If YES, What type? (cigarettes / vape / nicotine gum/patch / other) + How much?
Cannabis / Other Substances
Please Select
No
Yes - rarely (a few times per year)
Yes - monthly
Yes - weekly
Yes - daily
Prefer not to say
What substance(s), how often, and what effect on your sleep/mood/nervous system?
Digestion Most Days
Normal / regular
Bloating
Gas
Constipation
Diarrhea
Reflux / heartburn
Nausea
Stomach Pain / Cramping
Food feels “heavy” / slow digestion
Mixed / unpredictable
Other
Food Sensitivities
Please Select
No
Yes - suspected
Yes - confirmed
Not sure
Spiritual Practices & Experience
Tell us about your spiritual background.
Which spiritual practices do you engage in? (Select all that apply)
Meditation
Breathwork
Yoga
Prayer
Journaling
Somatic work
Energy work
Ceremonial practices / ritual
Nature-based practice (grounding, time in nature, earth connection)
Sound healing (sound baths, chanting, toning, mantra)
None currently
Other
How long consistently?
Frequency per week
Please Select
0 (not currently)
1–2 times
3–4 times
5–6 times
Daily (7x/week)
Daily + extended (7x/week + longer sessions)
It varies week to week
How many years have you been engaged in spiritual practices?
Please describe your experience with spiritual practices.
*
Past teachers/mentors
Ceremonies / plant medicine
Please Select
No
Occasionally Regularly
Mental Health & Support
Your mental health background and support system. This section helps assess safety and pacing. Answer only what feels appropriate. Honesty supports clarity.
Are you currently in therapy or under psychiatric care?
Yes
No
Are you taking any medications that affect mood, sleep, or nervous system regulation?
Yes
No
Have you ever experienced any of the following?
Panic attacks
Dissociation
Mania or hypomania
Psychosis
Suicidal ideation
Severe PTSD Symptoms
None of the above
Do you have a current support system (therapist, psychiatric care, counselor, trusted friends/family)?
*
Yes
No
If yes, please describe your support system.
RESPONSIBILITY & FIT
Willing to implement agreed practices?
Please Select
Yes
No
Unsure
Patterns you need to stop repeating
Consent & Acknowledgement
By submitting this form, I confirm: I consent to being contacted via WhatsApp about my application and next steps. I understand this work is spiritual/educational support and not therapy, medical advice, or crisis care. I take personal responsibility for my wellbeing and will seek appropriate professional support when needed.The information I’ve provided is accurate to the best of my knowledge.
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