The Earth-Heart Institute of Vision and Healing
2008 Course Application |
Name: ____________________________________________________________________________________________
Last First Middle Initial “Nickname”
Male ⊂⊃ Female ⊂⊃ Date of Birth ______/______/______
Address: __________________________________________________________________________________________
___________________________________________________________________________________________________
City State Zip Code
Home Phone (_________) __________________________ Work Phone (_________) __________________________
Email ______________________________________________ Cell Phone (_________) _________________________
How did you hear about us? _________________________________________________________________________
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Programs Available
√ place a check mark by each event you wish to attend
(call to discuss the Mentoring program)
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Wilderness Vision Quest
Suggested Donation* $650
S E L E C T D A T E
⊂⊃ Oregon, May 17-24
⊂⊃ The Pine Barrens, NJ July 26 - Aug 2
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Protector Course
Cost $950
⊂⊃ Pine Barrens, NJ
June 21 - 30 |
Seven Levels of Quest
Cost $875
⊂⊃ Pine Barrens, NJ
July 24 - Aug 2 |
Lighten Up: A Healing Retreat
Cost $475 ($550 after May 10)
+ $500 Room & Board
⊂⊃ Joshua Tree , CA June 11-15 |
Sacred Heart of Darkness
Cost $700
⊂⊃ Malibu CA March 23-27 |
Adv. Protector: Level 1
Cost $350 ($400 after May 1st)
⊂⊃ Pine Barrens, NJ June 30- July 3 |
Personal Intensive
Cost $1200 Individual, $2000 Couple
⊂⊃ Personal Intensive
(call or write for scheduling) |
Small Group Theme Intensive
Cost $850
⊂⊃ Fear
⊂⊃ Sanctuary |
100-Person Vision Quest
Suggested Donation* $650
⊂⊃ The Pine Barrens, NJ
Aug 8-15, 2009 |
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***Note on the donation for the Vision Quest. It is run on a suggested donation basis only to help cover the many logistical costs of running this program, so that we can continue to offer it (land rental, food and supplies, insurance, travel expenses, and staff). More importantly, the donation reflects your commitment and respect for this ancient practice, and for the people who will guide and protect you.
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Your application will not be considered complete unless we receive all of the following:
Please mail this application (with deposit, letter, medical form, and a recent photo) to
Earth-Heart, P.O. Box 926, Topanga, CA 90290 |
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