Changemakers Collective Enrollment

Step 1: Complete the enrollment form below.

Step 2: Once you've submitted your application, you'll be redirected to the payment page. IMPORTANT: Under "Order Summary" on the payment page you will need to update the program start date to "January 12, 2026."

Step 3: On the next page you will make your first payment installment today. The remaining 3 installments will be automatically deducted on the same day each month until the balance is paid in full.

Step 4: Once your payment is complete, you will receive a confirmation email with additional instructions on how to join the online platform!

First name

Last name

Pronouns

Mobile Phone

Address

How did you hear about this program?

Google/ Web Search

Social Media

Referral / Word of Mouth

Describe your current wellness practices and what you do to maintain them.

Explain any past experience you have with: Meditation/Mindfulness, Breathwork, Self-Inquiry or physical yoga practices.

What do you hope to gain from this training program for yourself?

How do you hope to use this training program once you have completed it?

This program involves self-study coursework, attending live/ recorded calls, participating in discussions and a regular wellness practice. These can be completed in an average of 3 hours per week. Please explain how you will meet this commitment.

Do you have any immediate questions or concerns about the training we can address for you now?

Is there anything else we should know that would help us create an optimal and safe learning environment for you?

IMPORTANT REMINDERS:

On the next page, under "Order Summary" you will need to update the program start date to "January 12, 2026." Skipping this step will result in your enrollment being set up incorrectly in our system and it will need to be completed again.

The first installment of this payment plan is due today. The remaining 3 installments will be automatically deducted on the same day each month until the balance is paid in full.

Thank you for your attention to this!

I understand I need to update my program start date under "Order Summary" to "January 12, 2026 on the next page.