2021 Facilitator Development Program - Greece (13-19 Sep 2021)
IMPORTANT:

√ FDP is highly intensive one year certification program designed by Rain™
√ FDP is by Application Only.
√ All Applicants will be interviewed and screened.

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Email *
Participant Information
Please fill out this form completely and return it within one week of receipt. ● The accuracy and completeness of your answers are important as a condition to your participation in this program. ● We will hold the information on this form in confidence. ● Please answer every question and sign your name in the appropriate place.

Full Name *
Name I Would Like To Be Called (On Name Tag) *
Home Address *
City, Province/State, Zip Code *
Phone Number *
Date of Birth *
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My Profession *
Please list your intention (5 reasons) of becoming a facilitator of Origin of Wisdom and/or Dr. Annie Lim International Inc. and/or your own program using the Origin of Wisdom methodology. *
How would being Origin of Wisdom and/or Dr Annie Lim International program(s) facilitator support your life’s purpose? *
If you have a personal message to deliver to others, what is it?
Please share 2 of your biggest learning experiences that you have experienced in your life. *
Please share 2 of your biggest “wins” in your life. *
What would you consider to be your weakness? *
What do you consider to be your greatest personal strength? *
What other program(s) have you attended? (Personal Development, Clearing, Body Work, etc) *
Describe your 1 year plan. *
Describe your 3 year plan. *
Describe your 5 year plan. *
Please List The Names Of All Family Members, Relatives, Friends and Business Associates Who Are Participating In This Program With You. (Use Enter To Create Multiple Entries)
I Have Read, Understood and Agreed to The Followings:
1 Year FDP program includes: *
Required
Confidential Health Condition Questionnaire
Are you under the care of a physician or a psychiatrist?
Clear selection
If Yes, Please Describe.
Are you receiving medication?
Clear selection
If Yes, Please Describe.
Have you had a history of heart trouble, rheumatic fever, diabetes, asthma, kidney or liver involvement, epilepsy, bleeding, disorder, or brain injury?
Clear selection
If Yes, Please Describe.
Are you allergic to any food or medicine?
Clear selection
If Yes, Please Describe.
Please advise us if you require special dietary requirements for your meals.
Have you had surgery with in the last year?
Clear selection
If Yes, Please Describe.
Have you had any serious illness or surgeries not listed that we should know about?
Clear selection
If Yes, Please Describe.
Is there any reason or physical condition why you could not participate in any physical exercise or late evening session?
Clear selection
If Yes, Please Describe.
Has anyone in your family ever attempted or committed suicide?
Clear selection
If Yes, Please Describe.
Emergency Contact
Name *
Address *
Phone *
Relationship *
By submitting this application to attend Dr. Annie Lim International Inc. Facilitator Development Program, I agree to the following terms and conditions:
Consent Agreement: I am advised that the Facilitator Development Program is an educational seminar and not therapy, and accordingly, I have no expectations along these lines. I am also advised that the Facilitator Development Program may include long hours and may be physically and emotionally demanding. I acknowledge that I have evaluated the advisability of taking the training in terms of all the history and circumstances of my life and I accordingly, agree to take full responsibility for the mental, emotional and spiritual well being I attain, as a result of the training. I am fully aware that the Facilitator Development Program may bring up incidents from my past, which may be emotional for me. I acknowledge and declare that I am voluntarily participating in the Facilitator Development Program. I hereby release Origin of Wisdom and Dr. Annie Lim International Inc. its founders, trainers, employees, any and all other Facilitator Development Program participants and the premises in which Facilitator Development Program is held, from any and all liability as a result of any physical, mental or emotional injuries, or damage to personal property suffered by me either during or as a result of my participation in the Facilitator Development Program.

I also acknowledge that I am in good physical and mental health and condition and have no ailment, disability or impairment, which (might) prevent me from participating in the Facilitator Development Program.

If I am in therapy, I warrant and represent that I have discussed the training with my therapist, and have ascertained from him/her that my participation is not likely to aggravate or activate any symptoms, illness or disorders which I may have, nor would it be harmful to my health or well being to participate in the Facilitator Development Program.

Confidentiality: It is my understanding that Facilitator Development Program is an experience, private and personal to each participant, and I accordingly agree to respect the confidentiality of all the participants and to keep all material shared or discussed by them, private and confidential.

Payment and Refund Policy: It is my understanding that the program payment is due in full by registration unless otherwise negotiated in writing. If I am paying with a payment plan, I understand that I do not receive any discounts for tuition and I must pay the total price.

Cancellation Policy: In the event, I am not able to attend the program for which I have registered, I must notify the promoters in writing at least seven days before the program starts. Provided I notify them before the seven day period, I will have the option to attend the next Facilitator Development Program or apply my payments to another program under the Dr. Annie Lim International Inc. umbrella, or substitute myself with another person not already registered. Please note: All payments are transferrable only and are not refundable. These options are available to participants who have placed their deposits or paid in full.

Release: I understand that the Facilitator Development Program may or may not videotape the program. I consent to and authorize Dr. Annie Lim International Inc. to use my name, voice, appearance, image, words and participation in whole or part in these recordings without compensation to me and that they may be used for educational and promotional applications.

By signing (or digitally signing) this document, I acknowledge that I have read and understand all of the above terms. I freely and voluntarily agree to abide by all of these conditions. Please send back (email, mail or by hand during registration) to RAIN or Dr. Annie Lim International Inc.
Is There Anything Else You Would Like To Communicate For Now? *
Checklist & Agreements *
Required
A copy of your responses will be emailed to the address you provided.
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