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A Year To Live 2025 - Wait List Application

* These fields are required

1 Welcome - Complete Wait List

3 Practitioner Details

Preferred or Chosen Name	We want to be respectful in addressing you. Complete, if different from legal name. Leave blank, if not.
What are your pronouns? *
Address line 1 *
Address line 2
City *
State/Province *	This list includes US and Canada, States/Provinces. For all other countries, please select "Other" at the end of this list and then select your country below.
Zip/postal code *
Country *
Birth date *	We ask this for validating your account; and for emergency purposes and rooming for in-person programs. We do not share this information outside of our organization.
Have you taken a previous Year to Live course at Spirit Rock? *	Yes No
YTL: Were you wait listed (did not get in) the last year or two? *	Yes No
YTL: Do you currently have a life threatening prognosis? *	Yes No
YTL: Do you anticipate needing a scholarship rate? *	Yes No
YTL: Which scholarship rate(s) make it possible for you to participate?	Scholarship Rate 1 - $750; Mudita/Karuna Scholarship Rate - $500; BIPOC Scholarship Rate - $500
By joining this list, you’re also agreeing to join our email list. *	I AGREE to join your email list.Uncheck the box if you do not wish to join our email list.
YTL: Class Agreements & Commitments - Important!	Engaging in the content of this course may be uncomfortable, challenging, and/or difficult at times (it can also be wonderfully liberating!). To get the most out of this training, we ask that you commit to: 1. Attending ONE of the Program Orientation sessions. 2. Attending a minimum of 10 of the 12 large group sessions live, including the first session which is REQUIRED. 3. Meeting with your Home Group monthly. 4. Engaging with the course material and practices as best you can (including completing all assignments and readings). 5. Participating as skillfully as you are able in all sessions and breakout groups. 6. Using your practice and stress management skills to stay as present as possible in the challenging times. 7. Maintaining a regular meditation practice (preferably daily) for the duration of the training program.
By checking this box *	I AGREE and COMMIT to the Requirements and Agreements.

4 Demographics