Writing Across the DharmaBridge Licensure Program Application
Full Name
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First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
What draws you to this program?
I love to write and want to deepen my practice
I'm a dharma student, or drawn to these teachings specifically
I have been in or currently am in DharmaBridge or one of Kelly's other programs
I already hold space for others (coaching, therapy, teaching, community leader, etc.) and want to add this to my work
I feel a calling to guide others through healing and awakening
Other (write-in)
What is your relationship to Śaiva Tantra and/or Tantric Buddhism?
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It’s brand new to me
I have some familiarity with it
I’m a practitioner
I have studied/practiced with Kelly
Other (write-in)
If certified, how do you see yourself using this?
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I want to weave it into my existing practice/business
I want to build a new offering or business around it
I want to bring it to a community I already serve (nonprofit, sangha, org)
I'm not sure yet – I want to explore
Other (write-in)
Do you have an existing community or audience you'd like to bring this to?
Facilitating this work means holding steady space for other people's vulnerability, grief, and breakthroughs. Are you currently in a season of life that will allow you the space and internal stability to show up for this program over the next several months?
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If there's anything about your current mental health, medical care, or life circumstances that you think we should know about in order to support you well in this program, you're welcome to share it here. This is optional, and shared only with Kelly and the support team.
Do you have support in place — a therapist, spiritual director, supervisor, or community — that you could draw on if this work brings up material for you personally?
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Yes
No
Other
Have you held space for others before – formally (teaching, therapy, coaching, ministry) or informally (community, family, friendship)? If yes, what did you learn about your own capacity in that role?
Can you commit to the full 20-week program arc – Wednesdays 12–1:30pm PT (Sept–Nov), plus peer practice sessions, (dates TBD) and the Jan–Feb practicum?
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Yes
No
Other
Are you open to receiving direct feedback on your facilitation from Kelly and mentors during the practicum?
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Yes
No
Other
Submit Application
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