AMS Joining Form AMS Training Joining Form - Strictly confidentialThis information is to assist us to support you on your training. It will only be read by myself, and the team where necessary. It is essential that you answer these questions truthfully, for your own safety. Please do not write your life story, just the headlines (we can discuss anything important in more depth). Thank you. 1. Personal DetailsName(Required) First Last Phone Number(Required)(including country codes):Whatsapp/Telegram Number(Required)(including country codes):Date of Birth(Required) MM slash DD slash YYYY Age Now(Required)Email Address(Required) Occupation(Required)NB Do you consent to your email and/or whatsapp number being shared with the group for the purpose of organising healing exchanges with other participants?(Required) Yes No 2. Person who may be contacted in the unlikely event of an emergency, relation to you & their contact details:(Required)3. How did you hear about this training? What/who influenced your decision to join this training?(Required)4. Do you consent to being added to our mailing list: for Fire Horse/Academy of Modern Shamanism news?(Required) Yes No 5.1 Are you currently taking any medication?(Required) Yes No 5.2 How might this influence your participation in the training? Please give details:(Required)6. Do you have any medical conditions that we should know about eg asthma, epilepsy, ADHD, autism, dyslexia, diabetes, fainting, HIV, heart condition, low/high blood pressure, allergies, migraines, cancer, mobile disability? Is there anything we need to know about how to support your wellness and safety eg in the event of an episode(Required)7. Do you have any history of psychological or mental illness, depression or suicidal tendencies? Have you ever had a psychotic episode? Have you ever been sectioned? If yes, please give details:(Required)8. Do you have any other mental, physical, emotional, spiritual, health or lifestyle conditions or habits that might compromise your ability to participate fully in the training, or that need special support? Please give details:(Required)9. What is your family background? How was your childhood?(Required)10. What are your major life traumas? eg deaths, separations, losses, abuse, accidents, injuries(Required)11. What are your recurring ‘patterns’, ‘stories’ or ‘issues’? eg anger, jealousy, fear, loneliness, shame, anxiety, addictions, phobias, sexual issues etc(Required)12. Is there anything else you think I should know about you, your mental, physical, emotional, sexual, spiritual health or lifestyle - if so, please share:(Required)13. What are your resources - what or who brings you joy, comfort and support?(Required)14. How might you cope with stress or difficult processes and emotions that might come up during this training - both at the training, and when you are at home?(Required)15.1 Are you confident in reading, typing out assignments and uploading them to the training portal?(Required)15.2 Have you attended any holistic training before?(Required)16. Do you have experience working in any kind of therapy, healing modality, health care or similar? Please describe.(Required)17. Please describe your relationship to Spirit, the Divine, Goddess, God, Source or Truth?(Required)18. Do you have a spiritual/meditation practice?(Required)19. What is your deepest value? Is your life in alignment with this?(Required)20. How do you envision Heaven on Earth?(Required)21. What do you hope to receive and achieve through this training?(Required)23. Do you have experience of working with plant and animal medicine/teachers? Yes/No(Required)If yes, roughly how many ceremonies have you attended with: A) Grandmother (tea from the Amazon) B) Grandfather (cactus from the Andes) C) Cacao (raw chocolate) D) Other medicines such as Kambo/Bufo etc E) I don’t understand the question F) None and I’m not interested G) None but I am interested. NB Please be discreet in emails or messages regarding these master teachers, not mentioning any plant names, thank you. 24. Are you interested in attending our masterclass ceremonial retreats?25. Is there anything else you wish to share or ask at this point?I have answered these questions truthfully, and have not withheld any vital information relating to health and safety. Today's Date(Required) DD slash MM slash YYYY Signature(Required)
