Standard Basic EMDR Training Pre-Application for Review

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Thank you for showing interest in the Envision Academy Basic EMDR Training Program. Please note that this application form does not guarantee you a spot in our training program. You must first receive a confirmation of eligibility and then complete your payment before we can guarantee a spot for you!
If you have any question, please email us at emdr-training@envisionservices.ca

Email *

Name *

First and last name

Best Email to reach you where you want to receive notification about the training (please ensure to check your junk folder in case our reply lands there). *

Phone number *

Highest degree completed *

Doctorate Degree

Master Degree

Currently a graduate Student (Students must have completed their core graduate academic coursework and must be in the practicum/internship portion of their graduate program. First year graduate students are not eligible.

Required

Are you a Licensed Mental Health Professionals? *

Yes

On a Licensing Track (applied and waiting for documents)

Required

What type of Licensure or Registration do you have? ex: I'm a Canadian Certified Counsellor (C.C.C.) *

Canadian Certified Counsellor (C.C.C.) with CCPA

Registered Social Worker (MSW)

Registered Psychologist (or provisional)

Licensed Mental Health Counsellor (LPC or LMHC)

Medical Doctor (must be licensed to practice in their state or province)

Registered Nurse (must have a Master of Science in Nursing (or higher) with a specialization in psychiatric mental health nursing)

Licensed Marriage and Family Therapist (LMFT)

Other:

Do you currently have a case load of at least two clients with whom you will be able to practice EMDR with after the first 3 days of training? If you don't anticipate being able to practice with clients, you do not qualify for this training. *

Yes

Required

I agree to attend all six days of the training: February 14, 15, & 16 2022, March 30, 31, 2022, and April 1, 2022. I also agree to participate in all 10 hours of consultation. (If you cannot attend any of the six full days of training, you will not be admitted to the training.)

Yes

Clear selection

Which payment plan do you prefer

1 payment of $2,299 + GST (Canadian $) or $1,800 (USD)

2 payments of $1,149.50 + GST (Canadian $) or $900 (USD)

4 payments of $574.75 + GST (Canadian $) or $450 (USD)

6 payments of $383.16 + GST (Canadian $) or $300 (USD)

Clear selection

I have read and understand the refund/cancellation policy? If not, please go back to our website to take a look at it (bottom of the page). *

Yes

A copy of your responses will be emailed to the address you provided.

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