PLEASE INCLUDE A $100.00 CONDITIONALLY-REFUNDABLE* APPLICATION FEE, TO BE CONSIDERED.

MAIL TO:
Lawrence Gold
The Institute for Somatic Study and Development
15 Esquina Road
Santa Fe, NM 87508

or pay on-line at http://somatics.com/training.htm

*Fee refunded to candidates not accepted due to limited class size or due to qualification requirements. Fee credited to tuition.

Question Title

1. date (Required.)

Question Title

2. Application Fee paid?

Fee must be paid to be eligible for consideration and to determine the tuition rate ("early bird" vs. "not-so-early bird").

Question Title

3. personal information (Required.)

Question Title

4. professional information (Required.)

Question Title

5. Please rate your level of proficiency. (Required.)

Question Title

6. What (if any) teaching experience do you have? (Required.)

Question Title

7. What experience (if any) do you have practicing as a somatic educator (of any school or lineage)? and for how long? (Required.)

Question Title

8. Please rate your level of proficiency. (Required.)

Question Title

9. What do you intend to achieve/acquire by taking training in Hanna Somatics Gold? (Required.)

Question Title

10. In which movement disciplines do you have training and experience (how much)?
(e.g., dance, martial arts, movement therapies, sports, somatic practices, etc.)

Question Title

11. Any physical complaints (how long)?

(Answers to this question may open an opportunity to have those issues resolved during training and/or point to preparation needed prior to training.) (Required.)

<SIZE=4><B>Have you:</B></SIZE>

Question Title

12. experienced the clinical (hands-on) form of Hanna somatic education? (Required.)

Question Title

13. practiced somatic exercises? (examples, below) (Required.)

  yes no
Hanna
Feldenkrais
Hanna Somatics Gold
Rolfing | Movement Integration ("Structural Patterning")
Aston Patterning

Question Title

14. read "Somatics" by Thomas Hanna? (Required.)

Question Title

15. studied a form of somatic education? which teacher/lineage?

Question Title

16. What other background do you have that complements a professional somatic practice? (Required.)

Question Title

17. Please feel free to add any other information that would indicate your proficiency in, and understanding of, somatic education.

T