If you have difficulty with the form, don't hesitate to ask us for help
A * means that the question is compulsory, you won't be able to send the form without it.
*Your Full Name
*Your Address (please include your country)
*Date of Birth (dd/mm/yyyy)
Please upload a photo of yourself so your tutor will recognise you. Click the browse button to find your photo on your own computer, then simply select the file. It will be uploaded automatically when you send the form. Maximum file size is 1MB and acceptable file types are *.gif, *.png, *,jpg, *.jpeg. Contact us if you have difficulties!
*Your email address
Home Telephone (include country code if applicable)
Mobile Phone (include country code if applicable)
How and where did you hear about the course? You don't need to complete below unless this is where you heard about the course, and brief details are fine.
Magazine or newspaper ad (details?)
Website (which one?)
Other (please specify)
*Would you like to join our Goddess Temple Mailing List? You will receive updates and information about courses and occasional Goddess Temple and Goddess House news. You can, of course, choose to unsubscribe at any time and, of course, you won't be added twice if you're already subscribed.
Full fee inclusive of 13 Moons: £845 (£65.00 per Moon circle)
A deposit of £65 reserves your place. You may also opt to pay for the seven circles from Samhain 2021 to Beltane 2022 inclusive, or from Beltane 2022 to near Samhain 2022 at a cost of £450 per seven circles.
Payments may be made in full or by eight instalments of £101.88 per month from 5 November 2021 for 13 Circles, or for seven Circles, five instalments of £82 per month, from 5 November 2021 or 28 May 2022, depending on which set of seven Circles you choose.
Instalment payments for the full course include a £35 admin fee, reduced to £25 for seven Circles instalments.
Signed Terms & Conditions are an integral part of the course application process and should be received by us within four weeks of your receiving confirmation of acceptance on the course.
Please make payments to: Glastonbury Goddess Temple.
*Please select from the list below your payment preference:
---Pay for all thirteen Circles in advancePay for the seven Circles from Samhain 2020 to Beltane 2021 in advancePay for the seven Circles from Beltane 2021 to Samhain 2021 in advancePay for all thirteen Circles by standing orderPay for the seven Circles from Samhain 2020 to Beltane 2021 by standing orderPay for the seven Circles from Beltane 2021 to Samhain 2021 by standing orderPay for all thirteen Circles by Paypal subscriptionPay for the seven Circles from Samhain 2020 to Beltane 2021 by Paypal subscriptionPay for the seven Circles from Beltane 2021 to Samhain 2021 by Paypal subscription
Please fill out the following questions as fully as possible so that your tutor can get a sense of who you are. The Glastonbury Goddess Temple will hold all information given in total confidence. Each of the text areas below will expand to allow 512 characters (with a counter below to let you know where you're up to). If you need more room, please send us a separate email with further details. It will help if we can easily cross-reference an email with your form, so please include in the email your full name, address and the course you're applying for.
Why do you wish to participate in this training?
What previous experience, if any, have you had in this area?
What are your expectations from this training?
Is there any other relevant experience or training you would like to tell us about?
*If you are applying for Seven Circles rather than the full Thirteen, do you wish to start in November 2021 or April 2022?
Because the nature of these trainings is transformative and energetic it is important for the teacher to know of certain mental & physical conditions. Answering these questions enables us to ensure your safe participation within the group and to recognise those times when it may be wiser to observe rather than to participate. It is a requirement for you to answer the following questions. All information is held in total confidence.
Do you suffer from any of the following conditions? (If necessary you can select multiple conditions by holding down the "Control" key and selecting as required).
EpilepsyDiabetesAsthmaHigh or low blood pressureHeart condition
*Do you have, or have you had, any medical problems of an acute or chronic nature?
*Have you ever had any mental health problems diagnosed or treated?
*Do you have any physical needs that it would be useful for your tutor to know about?
*Are you taking any drugs, prescribed or otherwise?
If you have included any of the conditions above, please give details. The text area below will expand to allow 512 characters (with a counter below to let you know where you're up to):
We do need you to sign aTerms and Conditions before you can be accepted on any course. Please download and print the Terms and Conditions now, then sign both copies and return one to us, with a note of your name and address.
If you don't have access to a printer, click here to request us to send you a paper copy of the Terms and Conditions.
Terms and Conditions can be returned to us by post, or may be scanned and returned by email but please note that we do need a legible copy that includes each page - we don't normally accept photos taken by a mobile phone.
Terms and Conditions must be signed and returned to us within four weeks of acceptance, as well as y our non-refundable £100 deposit.
The form won't send without your acceptance
*I have downloaded the Terms and Conditions for this course, or requested a copy by post, and will sign and return them by post.
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