QTBIPOC Mentorship and Apprenticeship Program Application Name * First Name Last Name Pronouns (ex: she, her, they, them, he, him, none, etc.) * Email * Phone * (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Do you identify as QTBIPOC/LGTBQI2S? * Have you taken a Tierra Rituals 9-week course? * yes no Are you in interested in Year 2, after completing Year 1? * What are you hoping to get out of this mentorship program? * Will you be able to attend every third Sunday of the Month? * Will you be able to make a $300 down payment or full payment within a week of getting accepted? * Is there anything else you want to share or add about yourself or your interest in this class? Thank you so much for applying. You can expect an email within 1 week. Have a lovely day.
