Step 1 of 3 33% General InformationName* First Last PronounExample: They/Them, She/Her, He/Him, Ze/ZirDate of birth* Date Format: MM slash DD slash YYYY Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Phone*Email* Add to M.E.T.A. mailing list? Yes No Emergency Contact InformationName* First Last Phone* 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 Significant internships, tutorials, apprenticeships, mentorshipsPlease share with us about your previous educational experiences. What, Where, Areas of Study, Licenses or Certifications you hold: (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)Mindfulness Related EndeavorsPlease 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 study of experiential, mindfulness-based approachesSignificant Personal Development TrainingsPlease share with us about any other significant personal development trainings you’ve attended and what you enjoyed or disliked about those experiences.STOP 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 firstname.lastname@example.org. 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 email@example.com. 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 life and career goals:*2. Tell us anything you want us to know about your learning style:*3. A significant element of the training will be the creation of a group dynamic that supports a vibrant learning environment. We will be intentionally forming a group and providing support for each group member to show up as their most adult self, allowing for and supporting the regulation of strong feelings as they arise and finding 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 other to be, difficulties you typically experience, etc*4. Are you currently in individual or relationship counseling? If so, is there anything you would like us to know about your experience:*5. 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, that you want us to know about or that may affect your participation in the training. None of these by themselves preclude participation in our trainings. However, as this is a training and not a group therapy program, we want to assure that students are able to adequately manage their psychological and physical processes, be self-aware, and able to access medical and psychological support as needed:*6. 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. Total $0.00 PhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.