Welcome to Foundation for Human Enrichment

	home

	about us

	professional SE training

	find a practitioner

	members section

	registration

	TOP

	resources

	research

	bookstore

Applicants must complete the information below and include the following upon submission of this form:

A current Curriculum Vitae (resume)
A professional biography which includes brief descriptions of the following: personal trauma you have experienced, description of your current practice, # of clients you see each week & a short statement indicating your primary interest in learning
Somatic Experiencing® (1 page).

All information submitted will be held in strict confidence. The FHE reserves the right to reject applications without explanation.

Thank you, FHE

Somatic Experiencing® Registration
(*Items with asterisks are required -- This form will not process without completing required items.)

*First Name:	*Last Name:

*Address:

*City	State	*Zip

*Country

*Home Phone:	*Work Phone:	*Cell Phone:

*E-mail:

Level of Education:
BA/BS MA PhD 0ther:
Professional Occupation:

Do you hold a health care license?:
Yes No If yes, which state?
License #:	Expiration (mm/dd/yy):

Grievances Do you have any grievances, complaints or actions pending or upheld against you for misconduct as a professional by any licensing, regulating or associative body?
No Yes If yes, please provide full details and copies of all relevant information.

Please use the Browse button to attach the following required documents:

A current Curriculum Vitae (resume)
A professional biography which includes brief descriptions of the following: personal trauma you have experienced, description of your current practice, # of clients you see each week & a short statement indicating your primary interest in learning SE® (1 page)

Attach Resume:

Attach Professional Biography:

Registration for Beginning I Training

Location of Training: (City/State) Dates of Training:

Instructor

How did you hear about this training?

Flyer Colleague SE Introduction Publication (name):

SE Fundamentals / Introduction

Conference Presentation by:

0ther:

All information submitted will be held in strict confidence. You will be notified by email of your acceptance into the program. The FHE reserves the right to reject applications, without explanation, and will provide a full refund.

The FHE reserves the right to cancel and /or reschedule any Beginning I class due to low enrollment 30 days prior to the start of the class. Should your class be cancelled, you will be notified as soon as possible. A full tuition refund will be issued or the funds may be transferred to another Beginning I class. Please note: The FHE is not liable for expenses incurred due to cancellation, including but not limited to airline cancellation fees or hotel cancellation fees.