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Enrolment Application

Shamanism 101 Coursework
Enrolment Application and Submission Form

All material submitted is confidential and private. For complete Privacy Notice click here.

Please complete all below. Please provide some detail regarding previous training, experiences and goals.

Full Name: (as you would want it on a completion certificate)
Email: (where you want your materials sent)
Complete Mailing Address: ( Avoid a premature send! Use one line, separated by commas. Don't hit your keyboard 'enter' button ) Number, Street, City, State, Zip Code, Country, etc. .
Daytime Phone (Including country code if outside the US)
How did you find out about this course series? If internet search, which engine and what terms?
What personal characteristics encourage your shamanic studies?:
What shamanic training or experiences have you had?:
Use of Quotes	Check this box for consent for Dr. Serr's use of anonymous quotes in books, articles, public awareness materials and publications including on the internet. All quoted material that is reasonably identifying of its source will be removed or altered to preserve confidentiality unless the author gives explicit written permission for their identification, such as in the publication of a photo, letter, etc.
Age:	Students must be over age 18, or else have their parent send to Shamanism 101 an agreement for their minor to take this training. My age is:
Support Newsletter	Check if you have (or will) sign up for the student support newsletter.
Terms of Responsibility and Liability	Terms of Responsibility and Liability (required). By checking this box, I promise to not do shamanic work that involves any degree of change of consciousness while in any situation for which common-sense or law would suggest or require that I have my full attention. This would include such activities as driving a vehicle or operating any kind of hazardous machinery, or otherwise placing myself in a potentially dangerous position, such as when climbing a tree, standing or sitting on a rock ledge, being near a roadway, etc. I am taking shamanic training recognizing that such work can destabilize my self identity and my relationship with the world around me, and that this can be very discomforting. I realize I have the authority to do or not do any of the exercises offered in any of the three levels of training, and that this will not jeopardize my passing the courses. I do not hold Dr. Steve Serr, Shamanism 101, or anyone related to this course series (such as teaching assistants) responsible for anything that happens to me that is in any way related to anything I am being taught, and in any way a consequence of my undertaking this training. By taking part in this training I do not and will not ever hold Dr. Steve Serr, Shamanism 101, or anyone related to this person or this training program liable for anything I ever believe might be damaging to me in any way. Instead, I recognize my own authority to learn, participate in, and derive and accept the consequences of this training.
Add any comments or anything to let me know more about you and your goals.

PRIVACY NOTICE

Shamanism 101 completely understands the need for privacy and confidentiality and assures you of this. This privacy notice discloses the privacy practices for http://www.shamanism-101.com. This privacy notice applies solely to information collected by this web site. It will notify you of the following:

1. What personally identifiable information is collected from you through the web site, how it is used and with whom it may be shared.

2. What choices are available to you regarding the use of your data.

3. The security procedures in place to protect the misuse of your information.

4. How you can correct any inaccuracies in the information.

Information Collection, Use, and Sharing

We are the sole owners of the information collected on this site. We only have access to/collect information that you voluntarily give us via email, enrolment form, or other direct contact from you. We will not sell or rent this information to anyone.

We will use your information to respond to you, regarding the reason you contacted us. We will not share your information with any third party outside of our organization, other than as necessary to fulfill a specific request limited to what you ask that you give to us in writing, e.g. to connect you to a fellow student.

Unless you ask us not to, we may contact you via email in the future to tell you about training events, courses or certifications, or changes to this privacy policy.

Your Access to and Control Over Information

You may opt out of any future contacts from us at any time. You can do the following at any time by contacting us via the email address given on our website:

- See what data we have about you, if any.

- Change/correct any data we have about you.

- Have us delete any data we have about you.

- Express any concern you have about our use of your data.

Security

We take precautions to protect your information. When you submit sensitive information via the website, your information is protected both online and offline.

We do not have access to or collect credit card or other banking data, that information is handled by PayPal. Wherever we collect personal information, such as you name, address, phone number etc. which you voluntarily provide on the enrolment form, that information is restricted to Dr. Serr, teaching assistant or other employee and used solely for the purposes of contacting you and facilitating your coursework at Shamanism 101 or responding to any other need that you specifically request in writing. Only employees who need the information to perform a specific job (for example, billing or customer service) are granted access to personally identifiable information. The computers/servers in which we store personally identifiable information such as that you provide to us to receive our periodic support newsletter are kept in a secure environment at GoDaddy.com.

If you feel that we are not abiding by this privacy policy, you should contact us immediately via email at drserr@shamanism-101.com .