Mindful Life Program MLY Immersion Semester Application
Thank you for applying to one of the MLY programs. Applications are accepted on a rolling basis. The spaces are allocated on a first-come basis.  

Those who successfully complete the MLY Immersion Semester may apply to enroll in Semester Two of either the Teacher Certification Year or Personal Development Year immediately following the Immersion Semester or at a later date.

For any questions on this application or the application process, please contact us at admin@mindfullifeprogram.org or by phone at (970) 633-0163.
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Email *
First Name *
Last Name *
Street Address *
City, State, Zip *
Country *
Phone Number *
Describe your interest in training in mindfulness. *
What has attracted you to the MLY Immersion Semester? *
What are your expectations about your learning and growth outcomes from this program? *
How do you hope to integrate what you learn? *
Please describe your meditation experience and practice at the current time and your history with it. Explain in detail what you currently practice and describe the nature, frequency and duration of it. *
Please describe your mindfulness experience and practice at the current time and your history with it. Explain in detail what you currently practice and describe the nature, frequency and duration of it. *
How does mindfulness inform and benefit your life currently?   *
Please describe your experience at learning a challenging new habit or skill and how you went about developing this. What was the nature of how you acquired the knowledge and the nature of the practice?  What were the internal obstacles? How often and in what ways do you practice and use it today? *
What personal strengths and attributes do you have that you believe would be useful in your learning and participation in the program? How do you see them being beneficial for you in your participation? *
How does loving-kindness show itself in your life? Please describe in general and illustrate with a specific example. *
How does compassion show itself in your life? Please describe in general and illustrate with a specific example. *
Describe what your concentration and focus is like when you are in a busy time in your life? *
Describe the role and extent of self-reflection in your daily life currently.
Do you have any specific learning needs that your MLP teachers should know about? If yes, please describe in detail. *
What possible other life commitments could potentially interfere with your commitment and participation in the program? *
Do you have any reading or writing challenges that may impact your participation in the program? If so, what can you share about helpful strategies you employ. *
Please describe your ability, access and comfort level in using a computer for video conferencing, word processing, emails and watching videos online. *
Do you have any medical, emotional, or mental health issues or medications that might in any way impact your learning and/or participation in the MLP program? If Yes, please describe in detail. *
Are you willing to commit to this program that is conducted over a six month period and will include the following requirements and action? Please check for agreement. *
Required
I have interest in considering Semester Two of *
Program Agreement
Please initial below each paragraph that you have read and understood the information below and agree to the program fee, payment schedule and cancellation policy.
Cost: The total program fee for the 2021 MLY Immersion Semester is $2700. The program fee includes all classes, individual mentoring, course materials and resources, a copy of Transforming to a Mindful Life, access to the online learning platform, membership in the Mindful Life Community™ or Mindfulness in Recovery® Community and access to the private Immersion Semester community space in the Mindful Life Network™.   *
Payment: An initial deposit is required to confirm your place in the program. An initial deposit of $700 is required to secure your place in the Immersion Semester while a deposit of $1400 is required to secure your place in the full year. Full payment is due by January 1, 2023. A monthly payment plan is required if payment is not made prior to June 15, 2022. An adjusted payment plan may be available on an individual basis.  *
Cancellation or course withdrawal policy: We understand that circumstances can change and do our best to accommodate changes. We do have the following cancellation and refund policy. Please contact us with any questions. Cancellations notified in writing prior to June 1, 2022: Refund minus $400 administration fee . Cancellations notified in writing on or after June 1, 2022, and before October 31, 2022:  Refund of program fee less $400 will be prorated. Notifications should be emailed to admin@mindfullifeprogram.org. *
References
Please list three personal references, outline their relationship to you and their contact details. These personal references may be contacted to ascertain your suitability to participate in the MLP.
Reference #1- Name *
Email address *
Phone number and time zone *
What is the relationship of Reference #1? *
Reference #2- Name *
Email address *
Phone number and time zone *
Reference #3- Name *
What is the relationship of Reference #2? *
Email address *
Phone number and time zone *
What is the relationship of Reference #3? *
Please share how you learned about the program.
Thank you for applying to the program!
After submitting your application, you will receive a confirmation of receipt of your application by email shortly. Your application interview will be scheduled with one or both of the instructors, and interviews of references will be completed. We notify applicants of their acceptance or status as soon as possible.  

With much appreciation, the staff at Mindful Life Program
www.mindfullifeprogram.org
A copy of your responses will be emailed to the address you provided.
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