EmailMe Form - 2016 GIM Level 1

Name
First Last
Email
Skype ID
Interviews with trainers may be conducted over Skype.
Date of Birth
DD / MM / YYYY
Address
Resume Upload
Upload your professional CV or fill up the questions below.
Tertiary Education Background
Please list (Affiliating Body / Name of Certification / Year Obtained)
Non-University Training (courses, seminars, workshops related to therapy practice).
Please list (Institution / Course Name / Date of Courses)
Professional Registrations
Please list (University / Year of Completion / Title of Degree)
Music Experience
(University degrees, OR tuition in music instrument, knowledge of history of music, theory of music, experience in music ensembles etc. OR description of affinity/enjoyment with music.
Relaxation and/or Imagery Experience
Experience with Imagery and/or relaxation techniques used in your therapy work.
Why do you wish to study Guided Imagery and Music Level 1?
(max 200 words)
Referee 1 - Professional
Name *
Email *
Phone
Referee 2 - Character
Name *
Email *
Phone