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2008 Application Form |
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Name: ____________________________________________________________________________________________
Last First Middle Initial “Nickname”
Male ⊂⊃ Female ⊂⊃ Date of Birth ______/______/______
Address: __________________________________________________________________________________________
___________________________________________________________________________________________________
City State Zip Code
Home Phone (_________) __________________________ Work Phone (_________) __________________________
Email ______________________________________________ Cell Phone (_________) _________________________
How did you hear about us? _________________________________________________________________________
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Programs Available
√ place a check mark by each event you wish to attend
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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 |
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***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.
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Call if you would like to commission a one-of-a-kind piece of handmade healing jewelry, or visit the website
www.Handmade-Healing-Jewelry.com |
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 |
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