Enrol for EXTIMACY – Center for the Practice of Somatic Extimacy

Full name, preferred pronouns & any relevant professional credentials you’d like to share (e.g., LCSW)

Full mailing address, email address & phone number

Please share any physical, cognitive, autoimmune, or sensory disabilities. This information supports us in organizing a course that meets everyone’s needs and anticipates everyone’s inclusive participation.

How do you socially identify? How do you locate your racial identity? This course is intentionally diverse – and across intersectional locations - and thus this information supports the manifestation of this intention.

What motivates you to participate in this course?

Please share a bit about your personal and professional experiences. In your response, please detail what prepares you personally and professionally to participate in this course. Please also include how you imagine it supporting your personal and professional goals.

Content for this course is potentially triggering and thus this course is inappropriate for those who are new to talking about and feeling into social difference, given the inevitable messiness that such engagement involves. This particular course is thus oriented to those who have consciously built sufficient inner capacity to stay present with and curious about ‘difference-centered’ conflict. Please detail your relationship with and commitments to staying present to yourself and others in social conflict, and please describe any external support you might come to rely upon should an experience in the class max your threshold for conflict. Your response to this question is essential: it is designed to keep you and others engaged and invested in this course, from start to finish.

Optional: Please share any additional information about yourself that can support Kesha and our class community in holding a quality of space that inspires your fullest participation within the context of this course.

Are you familiar with the Zoom platform?

Yes

The dates and times for this course are shown below. If there are any dates you know in advance that you cannot attend, please identify them by selecting them below

Module 1 - Mar 19-20 / 9am to 2:30pm PST

Module 2 - Apr 23-24 / 9:30am to 2:30pm PST

Module 3 - May 28-29 / 9:30am to 2:30pm PST

Module 4 - July 2-3 / 9:30am to 2:30pm PST

Module 5 - Aug 6-7 / 9:30am to 2:30pm PST

Module 6 - Sept 3-4-5 / 9:30am to 2:30pm PST

Module 7 - Oct 7-8-9-10 / 9:30am to 2:30pm PST

Module 8 - Nov 11-12-13-14 / 9:30am to 2:30pm PST

Please identify your fee tier

Tier 1: Household income at/under $40,000 & No retirement or family income/wealth Modules 1-5: $180 each / Module 6: $270 / Modules 7-8: $270 each

Tier 2: Household income at/under $65,000 Modules 1-5: $300 each / Module 6: $450 / Modules 7-8: $550 each

Tier 3: Household income at/over $65,001 Modules 1-5: $390 each / Module 6: $585 / Modules 7-8: $685 each

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PRACTICING EXTIMACY IN THE EMBODIED RELATIONAL FIELD

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PRACTICING EXTIMACY IN THE EMBODIED RELATIONAL FIELD

Enrollment Application