Art4Healing® International Certificate Program Application
Thank you for showing interest in the Art4Healing® International Certificate Program. To get started, you will need to fill out the following application. The Art4Healing® International Certificate Program is in no way associated with Brandman University. This international certification is solely certified by Art & Creativity for Healing, Inc. If you have any questions about the Art4Healing® International Certificate Program, please email
Name: *
Email: *
What country do you currently reside in? *
1. How did you hear about Art & Creativity for Healing, Inc.? Were you referred by anyone? If so, who? *
2. Have you taken a class using the Art4Healing® method? If yes, which one? *
3. In 2-3 sentences, please explain how do you plan on using the Art4Healing® method in your community? Do you already have a place in mind? If so, where? *
4. In 2-3 sentences, please describe yourself. Talk about your background, your personality, your goals, your hobbies and anything else you'd like to share. *
5. In 2-3 sentences, please explain what self-awareness steps have you taken or are taking to nurture yourself in order to achieve a healthy mind, body and soul? *
This class requires access to a computer or laptop, a computer or laptop with a webcam for virtual meetings, a video recording device that can use up to 5 GB of space (like your cell phone) to record you teaching, and a gmail account. Do you have all of the above? *
Have you read and understood the Art4Healing® International Certificate Program FAQ flyer? *
By entering your initials in the space below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge. *
Date *
We will review your application within 48 hours of the business week. Incomplete or insufficient applications will not be considered. We do not provide scholarships or payment plans. We are a small non-profit organization relying on the proceeds from the international certification program to pay for overhead costs, therefore allowing 100% of our grant/donation resources to go to our programs. In addition, please be aware that each participant is required to sign a training agreement and a photography and video waiver before participating in any certification activities. If you are not able to complete these prerequisites, your application may be denied.

Please note: Art & Creativity for Healing, Inc. does not provide refunds or pro-rating of any kind for this certificate program.

Due to the Holidays, we will process applications submitted between December 22, 2018-January 1, 2019 on January 2, 2019.

Never submit passwords through Google Forms.
This form was created inside of Art for Creativity & Healing. - Terms of Service