KLC Student Profile
BMC-KLC would like to get to know you and what you want to bring from your life experience. Will you be a resource to others and what support you need from others? We hope our questions will encourage you to be clear about yourself, your goals and expectations.

KLC Program Directors, Program Coordinators, and Faculty will review your profile.

After receipt of your profile Wendy Masterson, Director of Program Development, or a Program Coordinator will contact you should KLC require any further information.

Email address *
Name *
Your answer
Email *
Your answer
Phone (during course) *
Your answer
Date of Birth
MM
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DD
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YYYY
Emergency Contact during course
Your answer
List BMC courses or certifications you have completed.
Your answer
Please check that you agree to the following *
Required
Please provide a resume with your educational and professional background as a separate pdf.
Your answer
When were you introduced to BMC? How did you learn about KLC?
Your answer
What are your reasons for wanting to take this BMC course or program?
Your answer
What experience have you had with Body-Mind Centering®? Have you had individual sessions, classes or workshops with a Certified Teacher or Practitioner? Who? Number of hours?
Your answer
List your experience with other body-mind disciplines (movement, dance, bodywork, or other psychophysical approaches). Indicate whether casual, serious, amateur, semi-professional or professional.
Your answer
What are your expectations of this course or program? What are your expectations of yourself while enrolled in this course or program? Will you have work or family responsibilities while enrolled in this course(s)?
Your answer
An important aspect of this program is its experiential nature. You will be working deeply with yourself, closely with other individuals, and the group as a whole. You will be presented with a range of different teaching styles from our faculty and a range of different learning styles in other students. At times, you will be asked to explore BMC in a manner in which you may be unaccustomed to learning. Does this create a sense of apprehension or adventure in you?
Your answer
In regard to your learning style (visual, auditory, kinesthetic, intellectual) please share: 1) Your strengths and talents 2) areas you want to strengthen 3) have little or no experience.
Your answer
Given the experiential dimension of BMC and this program, it is necessary that applicants be emotionally stable. Students must be able to cope with the strong feelings that emerge from somatic experiential work and the rigors of intellectual work. Do you have any pre-existing physical, mental, spiritual, or emotional conditions that could affect your stability?
Your answer
Are you taking any medications for physical, mental, or emotional stability? Will you rely on medication(s) or could they limit your participation in this program? If yes, please explain.
Your answer
Please include the name and contact information for a teacher, mentor, or colleague that we may contact for reference.
Your answer
Is there anything else you want to share regarding your participation?
Your answer
A copy of your responses will be emailed to the address you provided.
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