2010 Shamanic Apprenticeship
Two Year Program
Enrolment Application

First Name:   
Last Name:   
Email:   
Street Address:   
City, State, Zip:   
Home Phone:   
Cell Phone:   

Date of Birth (MM/DD/YY):   
Estimated Time of Birth (if known):   
Birth date and time are used for divination purposes by Adam for determining the most appropriate applicants to work together for acceptance into the program.

Please summarize any previous training, experience, or studies in shamanism:   

Present a short essay on why you feel drawn to this program, what makes you prepared for the level of commitment, and what you hope to gain from it: