Apprenticeship Form - Breath of Remembrance

Apprenticeship Application

Apprenticeship Form

First Name *

Last Name *

Location *

Birthdate *

Phone Number *

Email *

What is your breathwork experience so far? *

Have you worked with Lana before? *

Yes

Have you tried Breath of Remembrance™ or Holotropic Breathwork before? *

Yes

How did you discover the Breath of Remembrance™ Modality? *

Why do you want to become a Breathwork Facilitator? *

Do you offer other healing or transformational services? If so, name them. *

Do you have a full time or part time healing business? *

What is your biggest challenge when it comes to the integration process? *

What is your vision for the future? *

When are you committed to start your Apprenticeship? *

What is the best way to contact you? *

Are you ready to invest your time, energy and finances into this Apprenticeship program? *

What else would you like to share? *