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MENTORS & MASTERS APPLICATION

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Name*

First Last

Company name

Email*

Phone

Website

Blog or Social Media link

Entheogenic Expertise

Which of these entheogenic related services do you offer or have expertise in?*

PREPARATION COACHING

SHORT-ACTING DETOX

TREATMENT OR NAVIGATION

LONG TERM ONE-ON-ONE INTEGRATION COACHING

SHORT-TERM AFTERCARE RETREAT

COMPLEMENTARY MODALITIES

If you said "other" or complementary modalities please say a few words about your offerings.

Please elaborate

What is your core specialty or area of expertise if you had to select just one.

Check all boxes that you have personally experienced*

Ayahuasca

Cannabis

Iboga/Ibogaine

Psilocybin

Ketamine

MDMA

LSD

San Pedro

Shamanic

Therapist

Indigenous

Retreat Center

Ibogaine Clinic

Iboga Ceremony

Medical Doctor

Psychedelic Guide or Tripsitter

Preparation or Integration Therapist/Coach

Visionary Artist

Journey Music

Entheogenic Author or Speaker

Entheogenic Mediamaker

Breathwork & Yoga

Nutrition, Detox & Dietas

EMDR

Neurofeedback

Biohacking

Addiction Recovery

Rehab

12-Steps

Halfway House

Complementary Modalities

Entheogenic Church

Non-profit

Entrepreneur

Check all boxes that are services or trainings you offer*

Ayahuasca

Cannabis

Iboga/Ibogaine

Psilocybin

Ketamine

MDMA

Shamanic

Therapist

Psychiatric

Medical Doctor

Indigenous

Retreat Center

Ibogaine Clinic

Iboga Ceremony

Psychedelic Guide or Tripsitter

Preparation or Integration Therapist/Coach

Visionary Artist

Journey Music

Entheogenic Author or Speaker

Entheogenic Mediamaker

Breathwork & Yoga

Nutrition, Detox & Dietas

EMDR

Neurofeedback

Biohacking

Addiction Recovery

Rehab

12-Steps

Halfway House

Complementary Modalities

Entheogenic Church

Non-profit

Entrepreneur

How many high-dose entheogenic journeys have you personally experienced?

1-3

3-10

10 or more

Dozens

Hundreds

Upload a bio or manuscripts if relevant

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