TREE OF LIFE CENTER APPLICATION:
280-hour POLARITY THERAPY Professional Energy Healing Training
Foundational APP- Level 1
We are an American Polarity Therapy Association (APTA) Approved school and
a Nationally Certified Continuing Education Provider with NCBTMB # 3129991-00
Name ___________________________________ Pronoun______________ Date of Birth _________________
Address____________________________________________________________
Phone’s (cell) __________________________(Other)________________________
Email______________________________________________________________
Occupation__________________________________________________________
NC LMBT Licence #__________________ for Continuing Education
OR Check off all that apply:
I am already a licensed healthcare provider and would like to add Polarity Therapy to what I do________
I am interested in pursuing the APTA training levels to become a BCPP (Board Certified Polarity Practitioner)_____
I plan to take this course for self-care and sharing with family and friends ________
Other____________________________________________________________________________
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, & energy work or bodywork you have received in the past.
C. Describe your learning needs & 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. We have an outdoor and indoor teaching space.
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 and externally that help you when you are stressed out.
I. Do you have any dates that you are unable to participate in the listed training dates?
Prerequisite Requirements:
To take our full training, you will need to participate in TLC's Intro to Polarity Therapy 1 and Intro to the Chakras & Elements before the start of our program to make sure we are all a good fit for one another. I have attended Intro 1 date:_____________& Intro 2 date:_____________
To apply to this program, please:
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Complete all application questions and email them to jmdchi@mindspring.com or mail them to the address below with a $100 application fee that will go toward your total tuition.
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Upon acceptance into our program, a $500 Deposit is due by January 23rd to reserve your space.
Payment options: -Venmo @JaniceMarie-Durand
or -mail a check made out to Janice Marie Durand or Cash:
If you are paying the entire tuition, please send a Check or Money order and do not pay it via Venmo
Thanks!
Tree of Life Center
Attn. Janice Marie Durand
4316 Bradford Ridge Road
Efland, NC 27243