Registration Name * Prefer to be called Address Home Phone * Business Phone Fax Email Address * Date of Birth Current Employment Name & Start date of Program you are applying for * Choose Course Craniosacral Biodynamics Lymphatic Biodynamics One Day Intro to Craniosacral Aromatherapy How did you hear about the School of Inner Health? Discuss your Intention for enrolling in this training program, and what you hope to gain from it. Describe your current professional practice — the nature of this practice, average number of clients per week, years in practice. The training you are applying for will bring up personal material. Are you willing to commit to getting professional therapeutic support outside the training as needed? : Please initial here to confirm this commitment. I agree to have a professional therapist to work with between modules in the event that my personal/emotional issues arise in the course of this training. Initials: * Describe any difficulties/challenges you have with either classroom learning or at-home study work. How would you like to be supported with these challenges?