Certified Listener Poet Program Application
Thank you for your interest in our Certified Listener Poet program! Anyone who wants to deepen their listening practice and appreciates the power of poetry to make the world a better place is a star in our book.

After submitting your responses, you'll be directed to complete two additional steps to complete your application:
(1) pay the $25 application fee at https://www.goodlistening.org/application-fee
(2) schedule your interview at https://goodlistening.as.me/CLPapplicantinterview

We will review applications on a rolling basis.

**Note: As you're preparing your answers, we recommend you draft your answers in a separate document and paste them into this form when you're ready to submit your application.
Sign in to Google to save your progress. Learn more
Name *
Email *
Phone *
Geographic Location *
How did you find out about this course? *
Describe any connection to/ experience with TGLP. *
What are your connections to healthcare? *
Tell us about your writing experience. *
Please share a short writing sample (one page is plenty). This does not need to be a complete work, nor does it need to be poetry. It only needs to be original, written by you. We'll only use this to verify your ability to write clearly.   *
How do listening skills show up in your life? *
What draws you to this Listener Poet training right now? *
Which cohort are you most interested in joining? *
Who will be responsible for your course tuition? *
Which tuition rate applies to you (all tuition from this course supports the nonprofit work of The Good Listening Project)? *
Is there anything else you want us to know?
How might we improve this application process?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of The Good Listening Project.

Does this form look suspicious? Report