SHIP 2015 Application SHIP 2015 Application Registrant Date: Full Name:* Also Called: Age: Date of Birth:* Time:* Birthplace:* Address:* How long have you lived at this address: Phone Numbers Home: Work: Mobile: Email:* Web Site: How did you hear about this workshop? Family Relationship status: How long? Children: Ages: Parent Living: Ages: List significant others, including names, ages, and relationship: A brief summary of your birth process, if known: Work, Education and Health Place of employment: How long? Please list: Illnesses, injuries or surgeries: Any chronic illness: Level of education: Degrees, Certifications, Training (including domestic skill): Do you see a therapist? How long? Do you struggle with Depression / Anxiety? Have you ever been hospitalized for mental or emotional related issues? If yes, what dates: Biography Write a short autobiography emphasizing the important milestones in your life. Please include healing modalities you have experienced, types of therapy you’ve done, spiritual paths and related workshops you have attended. Include your vision for your healing and training goals, why you are drawn to this workshop and what you hope to gain from this experience. 2015 SHIP Dates: March 13, 14,15: The Spiral Path & 5 Elements of Change May 15, 16,17: Family of Origin: Freeing the Inner Child August 21, 22, 23: Meeting Your Shadow October 16, 17, 18: Embracing Your Inner Beloved December 11, 12, 13: Sacred Purpose Workshop Hours: Begins at 9 am on Friday and ends at 5 pm on Sunday of each workshop weekend. Attendance at all sessions within the weekend is required. Meals & Lodging: Your program donation includes workshop teachings and materials, plus meals and lodging at Lake Doniphan Retreat Center. Included meals: Lunch on Friday through Lunch on Sun. Donation: Shaman’s Heart Sanctuary is a 501c3 non-profit spiritual organization. The donation for each SHIP segment is $675. The Early Bird discount is $575 if registered by three weeks prior to each segment of SHIP. Additional Discount: If you register for all five workshops of the SHIP series, the price drops to $535 per workshop – grand total for the full SHIP journey is $2675.00, which includes food and lodging. Prices for SHIP workshops may vary with different Venus Rising congregations around the country. Ordainment: Upon completion of all five SHIP workshops, you will be eligible to become ordained as a Shamanic Minister, if you so choose. SHIP is also the first level of training to become a Shamanic Breathwork™ Facilitator. University Credit & CEUs: All Shaman’s Heart Sanctuary workshops can be taken for credit with Venus Rising University. NAADAC CEU’s are also available. Please inquire during your interview about VRU credit or CEU’s so the proper paperwork can be completed prior to the start of the workshop. Registration: When you submit this application you will be re-directed to the S.H.I.P page. If you have completed your interview with Laura Wolf, please scroll down to the bottom of SHIP page and click on the registration link. You will be taken to the registration page where you can use the link to pay by credit card or call Laura Wolf at 816-560-6208 if you prefer to pay by check. I confirm that all information contained herein is true and correct to best of my knowledge. I understand that if accepted into this experiential workshop, I am committed to showing up at all of the sessions. Shaman’s Heart Sanctuary is a 501c3 congregation of Venus Rising Association for Transformation and is recognized as such by the IRS. Donations for ministerial teachings are tax deductible as a charitable contribution. Please ask the Shaman’s Heart Sanctuary office for a receipt for your tax-deductible contributions.