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Application Form for Somatic Experiencing Training
Somatic Experiencing 3 Year Professional Training Program
Date: *
Full Name: *
Company:
Full Mailing Address: *
Phone (Work):
Phone (Home):
Phone (Mobile): *
Email: *
Level of Education: *
Professional Title/Occupation: *
License #:
Area(s) of Specialization: *
Beginning I Dates: *
Upload your current Curriculum Vitae (CV) or résumé *
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Required
How did you hear about the SE Professional Training? *
Please provide answers to the following questions
Has any grievance, complaint, or action been brought or filed against you before any licensing, regulating, associative, or legal body for any violation or misconduct of any kind? *
(If yes, please email an explanation including all details and relevant information that you are legally permitted to disclose to seartin@seartin.org)
Describe your professional practice: *
How long have you been in practice? *
How many clients do you see on a weekly basis? *
If you do not have a professional practice, are you a student in a psychology-oriented master's program? *
Please briefly state your reason for taking the SE Professional Training: *
I've had a major traumatically-stressing event within the past year: *
I understand that the SE training may trigger past traumas: *
I understand that the SE training may trigger past traumas: *
If applicable, please provide an example of any additional relevant professional training, education and/or professional experience(s) (not already included in your CV/résumé or previous answers), that may have prepared you for the SE Professional Training:
All information submitted will be held in strict confidence. Once we have received your complete application packet you will be notified. Applications are approved on a case-by-case basis. The Somatic Experiencing® Trauma Institute reserves the right to approve or deny any application, and/or accept or reject the participation of any person in its sole discretion and in accordance with its policies and the law.

Refund policy: Once accepted into the program, a full refund, less a 100€ administrative fee, will be issued if you voluntarily withdraw from a class.Or, a 50€ change fee will be assessed if you voluntarily transfer your tuition to another class location. Certain restrictions apply.
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