Vedic Somatic Therapist Training Application Form
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Your Email *
Name *
Current Street Address *
City *
State/Province *
Postal Code *
Phone *
Date of Birth  
(Place and time of birth, if known)
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What previous training have you had in Alternative or Energy Medicine, if any? Please explain. 

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What work experience do you have in client-based practice, if any?
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Please write a paragraph about why you are inspired to take this program *
Please write a paragraph or more explaining what you hope to be able to do our share from taking this training. 
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Please indicate who referred you or how you found our program
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Is there anything else you feel called to share?

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