Shadowlands Application Form Name* First Last Date of Birth* Date Format: MM slash DD slash YYYY Mobile Number*Email Address* Relationship Status*Ages of living Children (if applicable)Postal Address* Street Address Suburb / City State / Province / Region ZIP / Postal Code What has drawn you to Dancing in the ShadowLands and what is your hope for attending this program?*Please explain your current understanding of what your shadow is and how it affects your life.*Do you personally have any history of physical/sexual/domestic violence abuse or alcoholism/addiction, psychosis? To your knowledge, did any of your ancestors?*Are you currently taking any anti-depressants or medication?* No Yes In the past yes, but not any more Dancing i the ShadowLands is for your personal and educational purposes. Are there areas of your emotional and mental health that you feel vulnerable and unable to accept self responsibility for?*Have you suffered from abuse, trauma or surgery to your reproductive area (including if you feel to share, rape, traumatic births or abortions)? (This is asked so that I can make our work together safe for you).*How do you make room for grief in your life? How do you process your losses?*In what area of your life and with whom do you habitually close your heart and fall into hatred or contempt? <i>ie your mother, International politics etc</i>*When did you first feel ostracism or hurt from women or 'sisterhood'?*How is your soul life nourished and supported within your (intimate / marriage) relationship? Is your partnership where you wish it could be? What id your habitual projection or bad behaviour with your partner*What do you currently most fear? How do you process your fears/work through them?*What do hope a year dancing with your Shadow will solve?*How do you deepen your relationship with yourself? How well do you like yourself on the inside as well as who you are to others?*Are you able to accept 100% responsibility for your life, including all your choices and the areas where life seems unfair or out of your control?*Please describe your spiritual journey and current spiritual practice or share what currently feeds your soul.*What is your experience of women’s groups and ‘circles’? What could be reasons for you not feeling safe with other women?*What do you most wish for in your world / life? Who do you wish to be and how do you wish to be different /more of after this 13 month MotherQuest?*Is there anything that you want me to know, so I can support you best during your participation in this program?*How did you hear about Dancing in the Shadowlands? If it was a friend(s) please name them so I can show my appreciation. xx*Which program are you or have you enrolled in?* MotherQuest : Journey Woman Training MotherQuest : Awakening to Sacred | Online MotherQuest : Dancing in the ShadowLands Ancestressy Homecoming Would you like to join our mailing list?* Yes. Please sign me up. I'm already signed in. No thanks, I'll just stick with MotherQuest EmailThis field is for validation purposes and should be left unchanged.