Name
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First Name
Last Name
Phone
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Email
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City
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Zip Code
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Can your connector or referral speak to your somatic or racial justice practice, if we have questions for them?
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How is your racial justice work evolving with your somatic practice? What's transforming in you since you started on this path?
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Why are you interested in the year-long course?
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Please tell us about your facilitation background and what interests you in embodied facilitation.
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Can you tell us about how you envision using the skills you learn in this course after it is complete?
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Do you have additional practices/expertise/lineage that you bring with you, that you’d like us to know about?
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What is your current commitment? (If you don't know what this is we will cover it in the course.)
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Have you completed an online or in-person course with Dara? If yes, when did you take it?
(This is not a requirement, but recommended.)
Please list the date of your previous ERJ course (such as St Louis Spring 2023). If you haven't taken a course with Dara before, and have completed another somatic training program, please share which one here.
Please list the name and date of your previous somatics course, if applicable.
In order for this course to be successful we ask participants to attend all four in person retreats. Can you commit to attend all four retreats?
In order for this course to be successful we ask participants to attend 80-90% of the virtual calls him in between retreats. Can you commit to attend 80-90% of the online course content?
Are you local to or currently living in the area?
To attend, will you need a place to stay?
After reviewing the COVID-19 policy, is there anything you would need added to make this session accessible to you? Do you have any questions about the COVID-19 policy?
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For course material purposes, are you taller than 5'9"?
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At what level will you be joining this course?
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Your payment will be due upon acceptance to the course. If accepted, do you plan to pay in one lump sum, or would you like to discuss payment plan options?
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Donations and sponsorships of any amount to offset the cost of registrations for others are always welcome. Donations directly impact our ability to offer scholarships. We recognize that some people have access to funds that allow them to help pay for or offset the cost of other future participants. Especially if you are white, comfortably paying your bills, have an organization paying your tuition and/or have other class privileges, we hope you will consider the feasibility of making a contribution that is meaningful to you.
Do you consent to us sharing your contact information with other course participants? (For example, we send emails to all participants before the course begins and we would like to cc you. Similarly, we share a participant list after the course concludes and we would like to include your email and phone number.)
What access needs might you have around this session? What would make these four days possible and easeful for you?
We invite you to name needs below.
What additional information would you like to know about our time together?
Is there anything you want us to know? Any questions for Dara or other organizers of this course?