MAPUTLA RETREAT APPLICATION

1

Every submission is read personally by Heidi or Lowella— not a team member, not an automated response. If it is the right fit, we will begin. If it is not, we will tell you honestly and point you toward what is.

2

1. Your full name* This field is required.

First Name

Last Name

3

2. Your Email Address* This field is required.This is where we will respond to your application personally.

4

3. Where are you currently based?* This field is required.

City and Country.

5

4. Which retreat are you applying for?* This field is required.

1) Maputla Reset— Body (Nervous System, Longevity, and Biological Recalibration. Led by Heidi Apsara)

2) Maputla Awaken— Soul (Identity and Soul Awakening. Led by Lowella Hernandez)

3) I am drawn to both and not sure yet. I would love guidance.

6

5. A) What is happening in your life right now that is calling you toward Maputla Reset?* This field is required.There are no right answers. Tell us honestly, what brought you here? What has been happening in your body, your energy, your biology, and your sense of yourself?

7

5. B) What is happening in your life right now that is calling you toward Maputla Awaken?* This field is required.There are no right answers. Tell us honestly, what brought you here? Are you navigating a transition? A shift in identity? A quiet ache for something more? Tell us where you actually are.

8

5. C) Tell us a little about where you are right now. * This field is required.What is going on in your life, your body, your sense of self? We will help you identify, which retreat is the right entry point for your journey.

9

6. A) Which of the following resonates most strongly with your current experience?* This field is required.

1) Chronic depletion despite apparent external success

2) Hormonal disruption, sleep issues, or unexplained fatigue

3) Nervous system permanently activated— productive, but never genuinely calm

4) A body that no longer feels like mine

5) A body that no longer feels like mine

6) All of the above

7) Something different— I will describe in the application

10

6. B) Which of the following resonates most strongly with your current experience?* This field is required.

1) A major life transition (divorce, career change, relocation)

2) Identity dissolution— I am no longer sure who I am

3) The quiet exhaustion of performing a version of myself that no longer feels true

4) A deep pull toward something more— but, no clear direction

5) A spiritual awakening I do not know how to integrate

6) Something different— I will describe in the application

11

7. Have you attended a Maputla retreat before?* This field is required.

No— this would be my first Maputla experience

Yes— Maputla Reset

Yes— Maputla Awaken

Yes— another program with Heidi or Lowella

12

8. The investment for this retreat is: * This field is required.Maputla Reset: USD $7,500–$12,000 Maputla Awaken: USD $4,500–$7,500 Is this investment range something you are able to explore?

Yes— I am prepared to make this investment

I would like to discuss payment plan options

I need more information before I can answer

The investment is outside my current range

13

9. How did you find Maputla?