The Medicine Woman Tradition Intensive Registration
Please fill out– in its entirety– and return to mail@animacenter.org
We request:
• Your focused intentions and attention, openness and engagement
• A suggested sliding scale donation of $350 to $850, either upon arrival, or pledged to
be sent in installments later as you are able
This place and work depend on your support, even more so because the Center does not ask
for payment before helping like most places do. No one is turned away for lack of donation.
Those who can give more than the suggested donation will be helping make it possible for us to
serve those with little or no funds to contribute.
Postal Money Orders are much easier for us to cash, but personal checks are okay. Checks
and money orders should be made out to:
Gretchen Geggis
PO Box 688, Reserve, NM 87830
To pay by PayPal, go to www.animacenter.org and the Memberships page, then click on the
PayPal button.
All information is strictly confidential, and our mailing lists will not be sold at any time.
Full Name___________________
Address_________________
Email_______________
Phone (optional)______________
Your Job/Avocation/Purpose______________
How did you first hear about us?______________________
Briefly describe your interest in, and experiences with healing, nature spirituality/magic,
personal empowerment, transformation and the Medicine Woman
Way_____________________________
What is your level of knowledge and experience with wild herbs, the preparation of medicine,
and healing in general?_______________________
What is you level of familiarity with the wild plants of the mountainous and riparian
Southwest?________________________
Briefly describe your understanding of, or relationship, to plant
spirit__________________________
Birthdate
Month
Day
Year
Marital Status
Married/Partnered
Single
Spirituality or Practice_____________________
Date & Approx. Time You Plan To Arrive:_____________________
Are you interested in carpooling from the nearest airport?
Yes
No
Can you offer a ride to others?
Yes
No
Amount You Can Donate ($350-850 Suggested):_______________
Method Of Donating:
Money Order sent in advance
Check sent in advance
Cash donation upon your arrival at the Sanctuary
PayPal online
In installments, as you are able
Might you eventually also be interested in:
Assisting the Center’s work in other ways?
Forwarding Animá events announcements to your email list
Assisting with Animá outreach, such as posting flyers
Leading, hosting or arranging for an Animá presentation where you live
Helping start an Animá study/practice group in your area
Placing Animá Center books in local libraries
Encouraging area bookstores to stock Animá Center books
Internet outreach or research
Assistance linking with other websites
Photocopying
Donating a vehicle or equipment
Becoming a Supporter
Becoming a student of Animá?
Yes
No
Becoming an apprentice of Animá someday?
Yes
No
Personal counsel while here?
Yes
No
Optional:
Describe your relationship to or interest in the plant world_____________
Describe your interest or experience in natural healing and
herbs_________________________
Describe your challenges and frustrations, as well as the things you would most like to change
in your life _______________________
Describe your developed abilities, innate qualities, blessings and
gifts_________________________
As soon as we get your completed application, we’ll write back with confirmation, as well as
directions, practicalities, and what you will need to bring. We’re pleased to welcome you!