Application Received

Thank You

Your application has been sent directly to Rebecca. She reviews every application personally and will be in touch within a few days.

In the meantime, reach her at hello@rebeccajaxholistichealing.com

— Jax Healing Retreat

Jax Healing Retreat · Rebecca Jax

JAX Virtual Facilitator Training
Application

This application is reviewed personally by Rebecca Jax. Please answer each question openly and honestly. There are no right answers — Rebecca is looking for alignment, readiness, and genuine commitment to this work.

Fields marked * are required.

Your Details

Full Name *

Please enter your full name.

Email Address *

Please enter a valid email address.

Phone Number (including country code)

Country of Residence *

Please enter your country.

Your Time Zone *

This helps us plan the Initiation Weekend scheduling.

Please enter your time zone.

Instagram Handle (optional)

Website or Booking Link (optional)

Your Practice

How long have you been actively working with clients? *

Less than 12 months 12 to 24 months 2 to 5 years More than 5 years

Please select an option.

What modalities or healing practices do you currently work with? *

Please describe your current practice.

Who do you currently work with? *

Please describe who you work with.

Have you experienced Kundalini activation or energy transmission before?

Yes, multiple times — it is part of my regular practice Yes, a few times Once No, but I am called to begin through this training

Describe your personal healing journey. What work have you done on yourself?

Virtual Readiness

Do you have a stable internet connection and a quiet, private space for live virtual sessions? *

Yes, I have both I have reliable internet but am working on a private space I am still setting this up

Please select an option.

Have you experienced online healing sessions or virtual ceremonies before?

Yes, regularly Yes, a few times No, this would be new for me

What are your thoughts or feelings about the virtual format? Any questions or concerns?

Commitment and Availability

The six-month embodiment container requires weekly attendance at live virtual ceremonies. Are you able to commit? *

Yes, I am ready to commit fully to weekly attendance Mostly — there may be occasional conflicts I would need to make up I have concerns about this commitment — I want to discuss further

Please select an option.

The four Initiation Weekends require mandatory live attendance. Do you understand and agree to this? *

Yes, I understand and commit to all four weekends I need more information about the exact dates before committing

Please select an option.

Any known conflicts, travel, or life events across the next 7 months?

Your Intention

Why are you called to this training, and why now? *

Please share why you are called to this training.

What do you envision doing with this certification? *

Please share your vision.

Is there anything you are uncertain or concerned about?

How did you hear about the JAX Virtual Facilitator Training?

Investment

Which payment option are you intending to use? *

Full payment — $2,222 Two instalments — $1,111 × 2 I have a question about the investment — please contact me

Please select a payment option.

Agreements

I understand that all JAX course materials, content, and methodologies are the intellectual property of Rebecca Jax and may not be shared, reproduced, or taught without written permission. I understand that embodiment across the six-month container is a prerequisite for the Initiation Weekends, and that initiation cannot proceed without adequate energetic preparation. I understand that the four Initiation Weekends are live, mandatory, and cannot be replaced by recordings. I consent to photographs and video content captured during virtual sessions being used by Rebecca Jax Holistic Healing and Jax Healing Retreat for marketing, educational, and branding purposes. I confirm that the information provided in this application is truthful and accurate. *

You must confirm your information is truthful to submit.

Sending your application...

Thank You

JAX Virtual Facilitator Training
Application

EXPLORE

GET IN TOUCH

OUR ADDRESS:

EMAIL US

STAY IN TOUCH

DESIGN BY KINDRED STUDIO

Thank You

JAX Virtual Facilitator TrainingApplication

EXPLORE

GET IN TOUCH

OUR ADDRESS:

EMAIL US

STAY IN TOUCH

DESIGN BY KINDRED STUDIO

JAX Virtual Facilitator Training
Application