Step 1 of 3 33% Personal Growth Training ApplicationPlease save this application to your hard drive. When you have completed your application, save it again to your hard drive and return to the Training Overview page of the M.E.T.A. website: (http://www.meta-trainings.com/training-overview) and click on SUBMIT MY APPLICATION, which will open a new email. Please attach your completed application to the email and send to our Student Advisor, Selin Strait. If you have any questions or experience any difficulties, please contact our Registrar, Selin by email at: firstname.lastname@example.org for assistance. General InformationName* First Last Date of birth* Home Phone*Email* Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Emergency Contact InformationName* First Last Phone* Education(Please check all that apply) High School Some College Bachelors Masters Degree Advanced Degree (Ph.D., Psy.D., M.D., N.D., D.C., etc.) Where / Areas of Study?Previous Trainings You've CompletedM.E.T.A. Hakomi Comprehensive Training Year 1 Year 2 M.E.T.A. Professional Skills Training M.E.T.A. Model (Model 1) The Re-Creation of the Self (Module 2) M.E.T.A. Maps (Module 3) Trauma: A Unified Approach (Module 4) Attachement: Assessing, Engaging and Strengthening the Capacity of Love (Module 5) Working with Couples (Module 5) M.E.T.A. Personal Growth Training M.E.T.A. for Bodyworkers Module A M.E.T.A. for Bodyworkers Module B Additional significant trainingsWhat, Where, Areas of Study, Applicable Licenses or CertificationsSignificant internships, tutorials, apprenticeships, mentorships(Please list anything YOU consider a formative factor in your personal or professional development, whether you assisted in brain research at Harvard, or if Aunt Helen taught you fly fishing in Idaho) What, Where, Areas of Study, Applicable Licenses or CertificationsLicensures, other Certifications, Diplomas, Credentials, etc. What:What, Where, Areas of Study, Applicable Licenses or CertificationsSTOP HEREIf you have completed a M.E.T.A. professional development training (Comprehensive Training or M.E.T.A. Professional Skills Training any module 1 through 6 or M.E.T.A. for Bodyworkers module A or B) and submit your application to email@example.com. You do not need to complete the remainder of this application. **If you have not previously completed a full M.E.T.A. professional development training and this is your first full M.E.T.A. training, please complete the remainder of this application and submit it to firstname.lastname@example.org. Please insert a photo here*Accepted file types: jpg, png, pdf, jpeg.1. What is your vision or goal for applying what you will learn in this training? How does it fit into your career and life goals?:*2. Have you ever gone to a META/Hakomi trained Therapist? (Who & when?) If so, how has that effected your desire to take the training?:*3. Tell us about your learning style:*4. Please give us a brief commentary on your experience in mindfulness-related endeavors, meditation practices and intensives, etc. Let us know what draws you to further your personal development through an experiential, mindfulness-based training:*5. A significant element of the training will be the creation of a group dynamic that supports a vibrant learning environment. We expect students to interact as adults, to be able to regulate strong feelings and to find collaborative ways to solve interpersonal conflicts. Tell us about your experiences and style as a group member, how you resolve interpersonal conflicts, where you may need help with this and how you see yourself adding to the richness and preservation of the group. Include topics like leadership, extroversion/introversion, how you prefer others to be, difficulties you typically experience, etc:*6. Please let us know about any medical conditions or personal factors that you may have or have had in the past, including psychological diagnosis, abuse or trauma history, suicidality, or other issues that may effect your participation in the training. Feel free to be frank, as none of these by themselves preclude participation in our trainings. However, as this is a training and not a group therapy program, we do expect students to be able to adequately manage their psychological and physical processes, be self-aware, and able to access medical and psychological support as needed:*7. In a paragraph or two, describe what kind of person you are:*8. Is there anything else you would like to tell us that you feel would help us to know you better? Although not required, feel free to submit any materials such as brochures from your career or projects, creative work, etc. that you feel would be valuable to this application process:*Payment Option*CheckCredit/Debit CardApplication fee is $60. For Credit/Debit Card Payments there will be a 3.0% processing fee included in the cost of the application fee.Application Fee*Check if you agree to pay the application fee.Application Fee*Check if you agree to pay the application fee.Discount Code: If you have a discount code, please enter it here to apply. 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