The Sacred Circle Fellowship — Membership Application

The Sacred Circle Fellowship — Membership Application
Full Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
How did you hear about the Sacred Circle?
If referred, who referred you?
Have you worked with plant medicines before?
What is calling you to this work at this time in your life?
What does embodiment mean to you in your daily life? How do you currently care for your body, mind, and spirit?
Do you have a daily embodiment practice or spiritual practice? Please select.

Other
If "other", please list here.
By submitting this application you understand that membership in The Sacred Circle Fellowship is by invitation only and that submission of this form does not guarantee acceptance. All applications are reviewed personally by Keith Walters. You will be contacted within 3-4 business days.
Full Legal Name (typed signature)
Today's Date

MonthDayYear
Date
I understand and agree to the above
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By submitting this application you understand that membership in The Sacred Circle Fellowship is by invitation only and that submission of this form does not guarantee acceptance. All applications are reviewed personally by Keith Walters. You will be contacted within 3-4 business days.