2008 Application Form

                          Last                    First                 Middle Initial       “Nickname”
Male ⊂⊃    Female ⊂⊃
         Date of Birth ______/______/______ 
Address: __________________________________________________________________________________________
                 City                  State                  Zip Code
Home Phone
(_________) __________________________ Work Phone (_________) __________________________
______________________________________________ Cell Phone (_________) _________________________
How did you hear about us?

Programs Available
place a check mark by each event you wish to attend

Lighten Up: A Healing Retreat
Cost $475 ($550 after May 10)
+ $500 Room & Board

⊂⊃  Joshua Tree, CA June 11-15
Sedona Women's Retreat
Cost $450 ($525 after March 18)
$650 Room & Board

⊂⊃  Sedona, AZ April 23-27
Your Wild Creative Soul
Cost $150 Class fee
$140 Room & Board
$35 Materials fee

⊂⊃  Los Angeles, CA Feb 29-Mar 2
All-Women Vision Quest
Cost $650
⊂⊃  Ashland, OR (TBA)

100 Person Vision Quest
Men and Women

Cost $650
⊂⊃  Pine Barrens, NJ Aug 8-15, 2009

2-Week Retreat
Cost $1,200
⊂⊃  Malibu, CA - Oct 2008
Advanced Women's Retreat
Cost $500 (Before Sep 8)
Cost $550 (After Sep 8)
+ Cost $400 Room & Board
+ $45 Materials fee
⊂⊃  Ashland, OR (TBA)
One Day Getaway
Cost $75
⊂⊃  Los Angeles , CA

Private Intensive
Cost $500, $700, $900
⊂⊃  3-day, Los Angeles area

⊂⊃  4-day, Los Angeles area

⊂⊃  5-day, Los Angeles area

***Note on the donation for the Vision Quest. It is run on a suggested donation basis only to help cover the many logistical costs of running this program, so that we can continue to offer it (land rental, food and supplies, insurance, travel expenses, and staff). More importantly, the donation reflects your commitment and respect for this ancient practice, and for the people who will guide and protect you.

Call if you would like to commission a one-of-a-kind piece of handmade healing jewelry, or visit the website


Your application will not be considered complete unless we receive all of the following:
Please mail this application (with deposit, letter, medical form, and a recent photo) to

The Total Human™, P.O. Box 1437, Topanga, CA 90290
Cancellation Policy: 
If you cancel your reservation in a program you have applied for at least 2 weeks before the start of the class, of the $300 nonrefundable deposit, The Total Human™ allows $150 to be transferred (one time only) to any other The Total Human™ program within 12 months of the original class application. If you do not notify The Total Human™ of your cancellation at least two weeks before the start of the class, none of the deposit is transferable. No refunds are given after the start of a program.