Herbalism & Plant Spirit Medicine For Birth Care Professionals

Registration Form

The Gaia School of Healing & Earth Education California

~ Registration opens on June 21, 2019. ~

We invite you to register online, by filling out the following form completely. If you prefer, you may download the form here and email it to thegaiaschoolca@gmail.com. Please submit your $200 course deposit via PayPal to reserve your space.

Name

First Name

Last Name

Address

Phone

Facebook Alias

Our Gaia School Online Forum takes place in a ”secret group” on Facebook. If you do not have a FB account, please create one for our class use. You may use an alias. Please ‘friend’ Nicole Sessions, Marysia Miernowska and Gabrielle Mittelbach so we can add you to your private group page as well as the Gaia Forum.

Our Commitments:

We at the Gaia School are committed to doing our part in making Earth Medicine people's medicine to ensure that our work is reaching a diverse group of students. Our sliding scale is an honor system that allows those of us with greater privilege to pay more so that others can pay less. Our community agreement trusts you to pay what you truly can afford. Sliding scale is not an opportunity to give yourself a discount. Like Mother Nature, we believe in the economy of generosity. We offer you the option to pay in full or make payment plans. 2 Work Trade positions are available. All is described in the payment plan section below. To support the diversity of our student body, we ask you to please share with us your ethnic/cultural background:

Your Gender

Anything else you feel called to share?

ABOUT OUR HONOR SYSTEM TUITION:

The tuition for Herbalism & Plant Spirit Medicine for Birth Care Professionals is $2000 - $5000 for 70 hours of in-class training. The tuition may be paid in full or divided into a monthly payment plan. If you choose to pay your tuition in full, you may receive a $50 discount. We use an honor system designed to make the course accessible for all income levels. We are aware that our economy of generosity is not something you may be familiar with, so please read carefully how our community agreements and your participation makes a difference. The honor-based system is modeled after the generosity of nature and asks us each to pay what we can afford. We ask you to either pay the tuition in full, or to divide your tuition into monthly payments using one of the payment plans. The sliding scale tuition translates to the payment plans as $333.33 - $833.33/ month for 6 months plus the deposit. The lower end of our sliding scale is intended for those who need financial assistance and who have an income of 30k or lower a year. We are committed to making our Herbalism & Plant Spirit Medicine for Birth Care Professionals accessible to all income brackets. If you are a low income student and need financial assistance, we encourage you to contact us for additional support. We are offering 2 Work Trade positions this year. If you are physically able to help Nicole 40 min before and after class, please send us an email applying for the work trade position. Work traders receive $300 off tuition in exchange for helping with set up and clean up during their class + 5 hours of farm/ apothecary/office work during the school year. We thank you for participating in our economy of generosity! Please include your contribution of any amount with this form. PLEASE CHECK THOSE THAT APPLY:

Upon acceptance I will be sending my tuition payment in full.

I have sent my deposit of $200 reserving my spot. (non-refundable)

I would like to make a donation of $ _______ in support of a sister or brother in need.

I would like to purchase a $50 Farm box from the certified organic farm where we have class. At each class gathering, I will get a box of seasonal vegetables, fruits, herbs harvested the day of class to take home! Thank you for supporting our farm with this new CSA opportunity!

I would like to apply for the work trade position

Donation Amount

Please do not send tuition checks until you have been notified of your acceptance to the program

*** Must initial to complete registration: ( _____ ) I understand that the full tuition is due by September 1st unless a payment plan has been set up or other arrangements made with permission.

TUITION PAYMENTS:

* Make checks payable to: The Gaia School of Healing California, and mail to The Gaia School of Healing, 21909 Alta Drive, Topanga, CA 90290 Refunds for half of the course tuition will be given if a student withdraws before December 1st. Thereafter, the full course tuition is due and no refunds are given if a student cannot complete the full course. Those with payment plans must pay the full tuition by the end of the course whether or not the course is completed in full, and will owe half of their tuition if withdrawing before the December 1st withdrawal date. *** Must initial to complete registration: (___) I understand that the full tuition is due by the end of the course, whether or not I am able to attend all the course dates. I understand that if I withdraw by the withdrawal date December 1st, only half my tuition will be due, or half will be refunded if I paid in full.

Because we will be holding healing circles and safe space for each other each class,

It's incredibly important that safe and solid space is held in this circle. This means coming with respect, openness, non-judgement, self-responsibility, self-care, and healthy boundaries. Each of us are asked to be conscious of how our energy effects or distracts the circle and each individual from their own deep work. Each person is always free to come to circle with what they are moving through internally, but asked to come with an ability to hold support for the work we're doing together in circle as well.

How did you find out about The Gaia School of Healing & Earth Education?

What are your specific interests that pertain to this course?

What are you most looking forward to learning? What are you hoping for?

What are some of your past experiences that have contributed to your interest in this course?

Please take some time to share anything else with Nicole about yourself.

Tuition & Payment Plan Form

The Gaia School of Healing Herbalism & Plant Spirit Medicine for Birth Care Professionals Course Tuition rate for 2019/2020 is $2000 - $5000 based on an honor system sliding scale. (Please Initial) _______ I have sent in the $200 deposit (non-refundable)

YOU ARE RESPONSIBLE TO PAY THE FULL COURSE TUITION REGARDLESS OF WHETHER YOU ATTEND THE COURSE IN FULL

A payment plan is offered for those who need help, and is not a ‘pay as you go’ option. Regardless of how many weekends you are able to attend, tuition is due in full by the end of the course. Please make sure that you understand this before signing up for the payment plan. We do not accept PayPal/Venmo payment plans, only automatic checks from your bank. PLEASE INITIAL ________ I understand that the full tuition is due whether or not I am able to complete the course.

Sliding Scale Annual Tuition - $2000 - $5000

Please decide for yourself what you are able to afford. If you can afford the higher end of the tuition scale, this allows a lower scale tuition to be available to those with lower incomes. A suggested guideline is the lower end is for those with who make 30k or less annually, are single parents, students, etc. Please initial - I am agreeing to pay a total of _______________ for my tuition to The Gaia School of Healing & Earth Education California and I have chosen the selected payment plan below:

Choose one of the Following Options

PAYMENT PLAN #1: Single Payment - One payment of $2000 - $5000 made in full by September 1st

PAYMENT PLAN #2: Six AUTOMATIC Payments - In order to use this option, it is a requirement to set up Automatic Payments through your bank. It’s a free service with online banking where you provide your bank with the school name and address, the payment amount and the date of payment and your bank prints and mails the school a check, on your behalf. In order to have this option approved by the school, you must set up the Automatic Payments through your bank, take a screenshot and email it to us as a confirmation.

Your Total Tuition Amount

Indicate the total amount you will pay for this course.

For Option 2 - Payment Amount

Please fill in your desired payment - Six automatic payments of _______________ (sliding scale $333.33 - $833.33 after deposit) on the dates listed below. 09/01/19 10/01/19 11/01/19 12/01/19 01/01/20 02/01/20

PAYMENT PLAN – AUTOMATIC PAYMENTS

I, ________________________________, understand that the full tuition must be (Please print your name) paid in full and by the last date of the course, regardless of whether or not I am able to finish the full course. I understand that I must set up an automatic payment through my bank for my payment plan to be accepted. I authorize these payments. The dates the recurring payment will be made are listed in the table above.

Date

YYYY