TT2 Sign-up - Mindful Academy Solterreno

TT2 Sign-up Application Form

Please fill out the form below to get started on your MBSR teacher training journey.

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Personal Details

Name*

Email*

Address*

Phone*

Emergency Contact Phone*

Date of Birth*

Passport / ID Number*

Additional Information

Exact Name you would like on your Certificate*

8-week MBSR Course?*

Have you taken part in an 8-week MBSR course? If so please include details including, date, location and teacher's name.

Meditation Retreat?*

Have you attended a Silent Teacher lead Mindfulness Meditation retreat of between 2 and 5 days? If so please include details including, date, location and teacher's name.

Please tell us a bit about yourself.*

Please tell us a little about yourself, including your current occupation.

Teaching experience?*

What mindfulness teaching experience (if any) do you have?

How long have you been practising meditation?*

Mental Health?*

Have you had any mental ill-health within the last few years, such as anxiety or depression? If yes please tell us about it here.

Taking Medication?*

If you are taking any medication at present, please say what it is and what it is for.

Life event in the last year?*

Have you had any disturbing life event in the last year, which may make the course difficult for you?

I have read and accept the Terms & Conditions.

I have read and accept the Privacy Policy.

I am happy to share my email with others in the same TT2 to help communication within the group.

Phone

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