Application Form

Certification Program Application Form

Click here for link to printable .pdf form

I, the undersigned:

____ am current with my Shamanic Astrology Mystery School (SAMS) Basic Membership dues.

____ have read and understand the Shamanic Astrology Certification Track Overview.

____ have read and understand the Shamanic Astrology Certification Requirements.

____ have read and understand the Shamanic Astrology Certification Registration Process.

____ have sent in my letter of intent to participate in the Shamanic Astrology Certification Program, along with a list of any SA classes that I have already taken, and why I am interested in this pursuit.

____ have sent in my Certification Application form.

____ have paid the one-time $100 application fee by check or on-line with PayPal at at the time of registration to complete the application process. (A $25 discount is applied to the application fee if the $75 SAMS membership fee is paid for at the same time bringing the membership & certification fee total to $150)

____ have ordered the required materials to begin the Certification Program.

Do you have any physical or health conditions that would limit your full participation in any of the required events?

____ No ____ Yes (If yes, please explain in your letter of intent.)

Contact and Birth information:

Name _______________________________________________________

Email __________________________________

Phone ________________________

Address ______________________________________________________

City, State, Zip _________________________________________________________

___________________ Date of Birth

___________________ Time of Birth ____ AM or ____ PM (Please be as exact as possible.)

_________________________________________________ Place of Birth (City, State & Country)

The philosophical and actionable commitment to be a member, certification or apprentice participant is that each individual must be willing to commit to participate with an open mind and heart. As SAMS recognizes the importance of the shadow, and is not a light polarized school, a certain level of personal, spiritual and emotional maturity is assumed and expected in order to fulfill the objective of the Mystery School. It is vital to the successful functioning of every SAMS circle and gathering that each member, certification and apprentice participant will agree to clear any personal issues with any facilitator or any other member on their own time so as not to negatively impede the circle or gathering.

With my participation in this program, I commit to act for the integrity of all SAMS gatherings.

Signed____________________________________ Dated _____________

Make check payable to SAMS and mail payment with this form to the Managing Director on the contact page 
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