2018 Training in Mindfulness Facilitation (TMF) Online Application
Please complete this online form below by October 13, 2017.

After you press "Submit" at the end of the application, you will receive a confirmation email with:

1) a copy of your application and
2) instructions on how to edit your response, if you wish, up until October 13, 2017.

If you have questions about this online application form or any other items on the Application Checklist, please email marcinfo@ucla.edu or call 310.206.7503.

Email address
Applicant Information
First Name
Your answer
Last Name
Your answer
Telephone (Home)
Your answer
Telephone (Work)
Your answer
Skype ID (if available)
Your answer
Street Address
Your answer
City
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State
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Zip Code
Your answer
Country
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Email Address
Your answer
Date of Birth
MM
/
DD
/
YYYY
Gender
Your answer
Name of Reference #1
Your answer
Name of Reference #2
Your answer
How did you find out about the TMF?
Your answer
Have you applied to the TMF in previous years? If so, when?
Your answer
Describe your current area of work, either paid or voluntary:
Your answer
What is your educational background?
Your answer
Mindfulness Practice History
With the following questions, please keep answers concise and to the point, but do not feel constrained.
When did you begin your mindfulness and/or meditation practice? What type of practice did you learn?
Your answer
What mindfulness meditation retreats have you attended? For each retreat, include 1) Name/Type, 2) dates, 3) lengths, and 4) teachers.
Your answer
What meditation retreats of other types (yoga, other contemplative practices, mantra, etc.) have you attended? For each retreat, include 1) Name/Type, 2) dates, 3) lengths, and 4) teachers.
Your answer
What mindfulness classes have you attended? What was the approximate date you attended a MAPs class through MARC?
Your answer
Are you currently working with a mindfulness or meditation teacher, and if so, who? Who have been your most important influences (you can include up to three books)?
Your answer
Are you currently part of any mindfulness or meditation-related community or sitting group?
Your answer
What are your plans (retreats, classes, or otherwise) for future mindfulness or meditation practice during the next year?
Your answer
What other forms of personal growth have you engaged in?
Your answer
Facilitation, Group History, and Intentions
With the following questions, please keep answers concise and to the point, but do not feel constrained.
Have you received training in psychotherapy, counseling, facilitation, group dynamics, or in any other field of personal growth?
Your answer
What, if any, previous experience do you have leading or participating in groups?
Your answer
Have you ever attended diversity training? If so, please list:
Your answer
If you are currently sharing mindfulness in your job or other capacities: In what way do you already share and facilitate mindfulness? How would you like to expand or assist in that process? Are there additional populations, institutions, groups, or communities you would like to work with?
Your answer
If you are not currently sharing mindfulness in your job or in other capacities: How do you envision sharing and facilitating mindfulness with others? Which populations, groups, institutions, or communities would you like to work with?
Your answer
What is it about mindfulness, from your experience, that inspires your interest in this program? Why would you like to participate in the program? Please be specific about how you see this program furthering your intentions with respect to sharing mindfulness-based practices. PLEASE FEEL FREE TO WRITE A SHORT ESSAY TO ANSWER THIS QUESTION:
Your answer
Additional Personal Information
With the following questions, please keep answers concise and to the point, but do not feel constrained.
MARC is committed to creating a diverse group of program participants in the areas of skills, experience, and background. Please tell us anything about yourself that would contribute to the group in this way.
Your answer
Is there any reason you would not be able to fulfill your commitment to participate completely in this program?
Your answer
Please note any other information you would like us to know:
Your answer
Tuition Discount Application
Would you like to complete a Tuition Discount Application?
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