Application for 18-Month Professional Training Programme

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Train to Teach MBSR and MBCT Starting in April 202

Email *

Name *

Address *

Mobile

Date of Birth

YYYY

Gender *

Male

Female

Other:

Emergency contact number

Occupation & place of work

Professional qualifications and training:

Please give details of the 8-week mindfulness-based course/s in which you have participated (including dates, location and name of teacher):

Please give details of any mindfulness meditation retreats you have attended:

Please give details of your experience of body awareness practices (yoga, Tai Chi etc.):

Please give the names and contact details of 2 people who can offer references for you:

In support of your application please write a brief summary here (approx. 500 words) outlining: 1.Your reasons for applying and what you hope to learn 2.Your meditation experience, including your experience of the 8-week mindfulness-based programmes (or equivalent) detailed above and the meditation retreats attended, if any, and your ongoing personal practice 3.The professional context in which you plan to teach 4.Any life challenges or events that have been significant and that may have a bearing on this application and perhaps say a little about what supported you through them. *

Clear form

Never submit passwords through Google Forms.

This form was created inside of mindfulness.ie. Report Abuse

Forms