Polygon Bokeh Background 10 EPS_orange_edited.jpg

Sacred Centers Academy
PROFESSIONAL APPLICATION

Professional Certification Application

Photo of You

Upload File

Upload supported file (Max 15MB)

First name

Last name

Phone

Street Address

City

Region/State/Province

Postal / Zip code

Best time to reach you

Birthday required

Occupation

Do you have experience with other chakra programs or teachers? If so, please list.

Formal education and years attended.

Workshops and other trainings.

Please tell us in detail why you want to undertake this program and what you intend to do with it when you have finished.

Please list your spiritual practices, indicating nature of practice, frequency, and duration (i.e. practice hatha yoga 4x week for one hour for 2 - 3 years, or practice meditation 2x a day for 15 years, or sing, chant, dance, volunteer, walk in the woods, etc.)

Any current medical conditions we need to know about?

Current or past psychotherapy

Name and phone number of emergency contact

Please mark the certification aspect you are interested in.

Chakra Teacher

Chakra Healer

Chakra Teacher and Healer

Can't decide

Your Signature

Date required

Thank you for submitting your application.

Polygon Bokeh Background 10 EPS_orange.jpg

Sacred Centers Academy PROFESSIONAL APPLICATION

Professional Certification Application

Sacred Centers Academy
PROFESSIONAL APPLICATION