First name
Email
Address
Phone number with country code
Social Media handles
How would you describe your profession and the role you play within your community?
What relevant training do you have in massage therapy, birthwork, and healthcare? Please include all degrees, certifications, licenses, and apprenticeships.
Describe your current relationship to your cycle/fertility:
Country of Citizenship:
By checking this box, you acknowledge that the enrollment fee does not cover airfare or travel insurance.
Date of Birth
Describe your current involvement in birth-work, body-work, and earth-work:
Explain how you believe this immersion will contribute to your personal development:
Share your values, perspectives, philosophies, and/or spiritual connection to birth and birth-work:
Given the socio-political and spiritual shifts we've experienced, describe your experience with COVID and relevant social-political movements in your community, country, and globally. How do you interact with individuals who hold opposing views, and what are your boundaries in shared spaces? How would you handle tension and disagreement in an immersive environment?
List any allergies or dietary restrictions:
Take this opportunity to share anything else you find important and ask any questions:
List any regular medications or herbal formulations:
By checking this box, you acknowledge that accommodations are shared and commit to sharing space with others in a respectful manner.
By checking this box, you understand that a valid passport is required for entry into Colombia, and any necessary visas or requirements from your country of residence are your responsibility.
I agree to submit the 30% deposit ($660.90) within 48 hours of acceptance to secure my place in OrganWise 2026 (Sept 12–19, Finca Ocelote, Colombia). The deposit is refunded in full if my application is not accepted.
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