Soothing the Longing Heart ~ January 2024

* Name

First

Last

* Email address

* Address information

Street Address

Address Line 2

City

State / Region / Province

ZIP / Postal Code

Country

* Number of years practicing meditation

* Meditation practice type, ex. Zen, Tibetan, Thervada, vipassana, jhana, breath awareness.

* Please share about your spiritual journey and practice and its influence on your interest in this program

* Please share a bit more about your life journey and its influence on your spritual practice and your interest in this program

* Please share about Dharma retreats or training you have completed in the last few years

* Confirmation

I confirm and agree to all terms outlined below.

All details above are complete and true. I understand by submitting this application I am not guaranteed participation in the Soothing the Longing Heart mentoring program. Should I participate in the Soothing the Longing Heart mentoring program, I accept full responsibility for myself during this training and waive all liability from Stephen Snyder and Awakening Dharma for all personal result or outcomes. I understand the Stephen Snyder is not offering professional medical or psychological advice and this program is not a substitute for consultation with a health care professional.