Application for the Rubenfeld Synergy Certification Training Program
Your information is confidential and will only be shared on a need-to-know basis with other faculty.
Email address *
Name: *
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Mailing Address: *
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Phone (best number to reach you): *
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Other Phone Number:
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How did you discover Rubenfeld Synergy? *
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What attracts you to Rubenfeld Synergy? *
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Briefly describe your current job/profession: *
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If you are looking to change professions, briefly explain what you're looking for and how Rubenfeld Synergy fits into your vision.
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If you are currently a holistic practitioner and/or bodyworker, or in a related field, why do you want to certify in Rubenfeld Synergy?
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Please list trainings you have received in bodywork, psychology, or other holistic practices: *
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On a scale of 1 (not at all committed) to 10 (very committed), how committed are to successfully completing the training program and becoming a Rubenfeld Synergist? *
Let's just hope it happens.
I'll do whatever it takes!
What skills, assets, and/or resources do you possess that will help you successfully train in Rubenfeld Synergy? *
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What challenges and/or obstacles have you experienced in the past when learning something new? *
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What did you do to resolve or handle those challenges or obstacles? *
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What support will you most need during the training program? *
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What support will you need after you've certified? *
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Keeping in mind that your answers are confidential, briefly describe your mental and physical health history. *
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Is there anything else you want us to know about you?
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