Application Form for Training Program

Contemplative Therapeutic Practice

All information is confidential.

Personal Details: Full name, address, telephone numbers, e-mail address.

 

Work history: Give (brief) details of your work history.

 

Intention: Write something about why you wish to attend the program.

 

Previous experience: Give details of your experience of receiving psychotherapy, counselling, bodywork, or group work.

 

Spiritual practice: Do you or have you had a particular spiritual practice?

 

Any psychiatric or medical history: Please give details of any psychiatric treatment or medical conditions.

 

Support: Please write something about what and who supports and nourishes you personally, physically, spiritually and professionally.

 

Is there anything particular happening in your life at present/recently that youd like me to know about?

 

Previous talks etc: Have you attended any of the previous talks/workshops on Core Process Psychotherapy? If so, which.