TREE OF LIFE CENTER
RPP Level -2 hour Somatic Energy Healing Training Application
150-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 _______________________________ Pronoun____________ Date of Birth _________________
Phone’s (cell) __________________________(Other)________________________
I would like NCBTMB Continuing Education for my NC LMBT Licence __________________
I am interested in pursuing the APTA training levels to become a BCPP (Board Certified Polarity Practitioner)_____
I am already a licensed healthcare provider and would like to add Polarity Therapy to what I do________
Track A- _______ I am enrolling in the entire Core RPP program. To apply for full-time students please:
Complete the application & Fee of $75 by Feb. 28th, 2023 and email it to email@example.com or mail it to the address below.
Place a $350 deposit by March 28th, 2023 of your commitment to the program (Both go toward tuition)
Track B- _______I am further along in my RPP education or have been approved to do Electives needed to complete. Please register & check off all modules & single days you are registering for.
Complete the application & Fee of $75 by Feb. 28th, 2023 that goes toward your final Module. Email it to firstname.lastname@example.org or mail it to the address below.
Place a deposit of the sum of a $25 (non-refundable) for each Module you are registering for below by March 28th that goes toward your total module fee due on the 1st day of each module.
Please register & Check all classes you plan to attend below.
______Orientation, practice day (mandatory for all participants to build the group container)
______Module #1- April 21-22 - Harmonic Zones & Advanced Elements work (+ zoom Apr. 17)
______Module #2- May 19-20 - As above, So below Cranium & Pelvic CNS Balance (+ zoom May 10)
______Module #3- Jun 16-17 - Spinal Harmonic Balancing (+ zoom Jun. 7)
______Module #4- Aug. 4-5 - Mysterious Sacrum (+ zoom)
______Module #5- Aug. 25-26- Craniosacral Breath of Life Intro- Pat Donohue (+ zoom Aug. 16)
______Module #6- Sept. 22-23 - Endocrine System (+ zoom Sep. 13)
______Module #7- Oct. 20-21- Adv. Air Element protocols, Integration & completion (+ zoom Oct. 16)
______One Day, Sat. July 15 -Somatic Processing, Ethics, Energetic Eval.
For Every student applying to Track A or Track B
On a separate sheet or via email briefly answer the following:
A. Why are your intentions and goals with participating in this RPP level of training with Tree of Life Center?
B. Describe pertinent training, experience, and Energy work or bodywork you have received.
C. Describe the learning strengths that you bring to this experience individually and in the group?
D. Describe any individual and group learning challenges you have that are important for me to know while you are enrolled in this program?
E. Are you willing to create outside resources and support beyond the training environment if needed for tutoring, counseling, or Somatic sessions?
F. Describe any resources and supports internally & externally that help you when you are stressed out.
G. Do you have personal/medical conditions or situations (physical, emotional, mental) which may affect the quality of participation in classroom activities, attendance, and coursework completion? Please describe.
I. Do you have any dates that you are unable to participate in the training dates listed on our website?
Payments Options include:
-Venmo @JaniceMarie-Durand -Zelle at email@example.com
-Cash or, -mail a check made out to Janice Marie Durand: 4316 Bradford Ridge Rd. Efland, NC 27243
Tree of Life Center
Attn. Janice Marie Durand
4316 Bradford Ridge Road
Efland, NC 27243