Earth School Shamanic Gatekeeper Training Application Form

Join the Journey around the Medicine Wheel

Please read the following before you start filling out the form.

  1. Completing the full application will help you and Earth School discern whether this training is appropriate for you. It is our intent to assemble a diverse group of students who would work well together as a cohort.
  2. We respect your privacy and will hold all your information in the strictest confidence.
  3. Please complete ALL sections of the application form below. Be as detailed and concise as possible. Leave any questions blank if you do not wish to provide an answer.
  4. The 5 sections of this form will take you between 30-60 minutes to complete. Copy and paste this PDF onto a Word Document, complete, and email info@bornastheearth.com
  5. You only need to complete ONE application form when applying for a selection of Modules (or for the ENTIRE 6 Month Training).
  6. Once we have received your application we will be in touch via email to set up an interview time with you and the training team.

I am applying for the following training: Check ALL that apply

Have you participated in any of these Earth School offerings? Please check ALL that apply:

The suggested Dana Donation is R1000-2000 per module or R5000-10000 for all 6 Modules. Please check ALL that apply:

By submitting this application form you agree that Glenn (Nangaku) Leisching / Born as the Earth Zen School can process and securely record your information.

1 + 14 =

We appreciate you taking the time to complete this form. We will be in contact once your application has been processed.

If you have any questions please don’t hesitate to contact us.