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Application 

 
 

October 27-28 , 2012
Chicago

Body-Mind Psychotherapy Introductory/Advanced Training Workshop
Details
nfo@bodymindpsychotherapy.co

 
 

Body-Mind Psychotherapy Training

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Application

   
 

"This experiential training is invaluable because Aposhyan models an embodied presence, which she supports in others through her direct sophisticated language."

 

—Sarah Turner, Counseling Student

 

 

Please send us an email with the following information:

Application for BMP workshop/training (date)__________ (location) ________________________

Name_________________________________________________________________________

Address_______________________________________________________________________

Phones (work)____________(home)____________ (cell)________________________________

Email__________________________________________

Occupation (Please include pertinent background in any helping professions including licenses, certificates, and registry. Have you ever had any professional grievances filed against you? If so, please add a full explanation and history of the resolution?)

Statement of interest in this workshop/training.

Professional References (please include address, phone numbers, and email)

A deposit (generally $100) is required for most events and is nonrefundable if accepted.

BMP training is a commitment. If accepted into this workshop or training, I agree to attend all classes and participate fully in a professional fashion. This includes giving feedback directly and in a timely fashion. I agree to the specified payment plan and understand that full payment is required regardless of attendance.

Student’s signature ____________________________________________________ Date_________

 

 

   
 
Contact Us  •  Email: info@bodymindpsychotherapy.com