Application Questionnaire for Guiding Embodied Inquiry with Individuals: A Training for Mindfulness Meditation Teachers 
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Name: *
Address: *
Email: *
Phone: *
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What is your training as a mindfulness meditation teacher? Please include dates and teachers and name/location of program(s).
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Please describe any other relevant training or education.
Please describe your experience teaching mindfulness meditation courses.
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Have you done mindfulness-based work with individuals? Please describe briefly.
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Please share something of your own growth path, including personal experiences with psychotherapy, mindfulness-based healing, somatic approaches to working with emotion, and other modalities.
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What strengths do you feel you bring to doing this work?
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What do you hope to gain from taking this course at this time? What are you wanting to learn?
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Are you able to commit to attending all components of the program? If not, what conflicts do you foresee?
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Do you plan to take the 8-Week Inquiry Course (Tuesdays, 6:30–9 pm Eastern Time, September 16-November 4 [Retreat day on Sunday, October 26, 10 am–4:30 pm Eastern Time])?

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Do you have any access needs in order to participate in this online program? If yes, please describe.
Do you plan to apply for scholarship for the GEII program?
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Is there anything else you would like us to know?

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