TREE OF LIFE CENTER
Somatic Energy Healing Training Application
225-hour Polarity Therapy Professional Training
We are a Nationally Certified Continuing Education Provider with NCBTMB # 3129991-00
& and American Polarity Therapy Association (APTA) Approved school.
Name _______________________________ Date of Birth _________________
Phone’s (cell) __________________________(Other)________________________
NC LMBT Licence #__________________ for Continuing Education OR
Check off all that apply:
I am interested in pursuing the APTA training levels to become a BCPP (Board Certified Polarity Practitioner)_____
I am already a licenced health-care provider and would like to add Polarity Therapy to what I do________
I plan to take this course for self-care and sharing with family & friends ________
How did you find out about this Tree of Life Center Polarity Therapy Training?
On a separate sheet or via email briefly answer the following:
A. Why are you interested in studying polarity and what are your intentions or goals with participating in this training?
B. Describe pertinent training, experience, and Energy work or bodywork you have received.
C. Describe your learning needs and preferences to help us support your development.
D. Describe the learning gifts that you can bring to the group.
E. Do you receive or have you received Somatic process-oriented bodywork before?
F. Please describe whether you have personal/medical conditions (physical, emotional, mental) which may affect the quality of participation in classroom activities such as movement and Gentle Energy Yoga/attendance or coursework completion or that could get stimulated in the training environment.
G. Are you willing to reach out for support to a Counselor or Somatic Practitioner if you are needing more processing resources during the training period if things are coming up for you?
H. Describe any resources and supports internally & externally that help you when you are stressed out.
I. Do you have any dates that you are unable to participate in the training dates listed?
To take our full training you will need to do an Introduction class or tutorial. Intro’s to either Energy Healing or Chakras & Elements needed to participate or possibly another class that you have taken with Tree of Life Center. Dates, hours & course you have participated in Tree of Life Center’s Introduction classes. (Specify is LIVE class or on Zoom)
To apply to this program please:
Complete the above application and email it to email@example.com or mail it to the address below.
Submit an application fee of $350 deposit to reserve your space.
-Zelle at firstname.lastname@example.org
-Paypal at email@example.com (Please add a 3.5% administrative fee that Paypal charges)
or -mail a check made out to Janice Marie Durand:
Tree of Life Center
Attn. Janice Marie Durand
4316 Bradford Ridge Road
Efland, NC 27243