Somatic Experiencing® Associates and
Practitioners Registry 2007 Application

Dear Somatic Experiencing® Participants, Practitioners, & Associates:

You are invited to be listed in both the printed and online version of the 2007 Somatic Experiencing® Associates and Practitioners Registry. The Registry serves as a vital resource both within the Somatic Experiencing® community and for those who are seeking information, education, and assistance in trauma healing. The Registry serves as the Foundation for Human Enrichment's primary source of referrals for all inquiries.

Please submit your completed application and payment to the Foundation for Human Enrichment by November 1, 2006. The 2006 Registry will be printed and available for distribution by January 31, 2007. The on-line Registry is available for viewing at our web site, www.traumahealing.com. Your photo will be included if received in a jpeg format with your Annual Registry application. Photos can be emailed to info@traumahealing.com.

Contributions and gifts to the Foundation for Human Enrichment are tax deductible as charitable contributions to a nonprofit organization. Annual Registry fees may be deductible as an ordinary business expense. Please make a copy of this application and payment for your records.




Application Due:
November 1, 2006
Distribution: December 31, 2006
First Name
Last Name
Company Name
Degrees/Certi.
(i.e. SEP, APRN, BC, CFT, Ph.D.)
Keep listing EXACTLY the same
 
 
Address
City
State
Note: California listings please specify:
Central CA Northern CA
Southern CA
Zip
Country
Work Phone
Fax
E-Mail
Website
SE Level
Professional Title
Professional Description
Printed and Web Page Practitioners Registry
$50 Beginning $75 Intermediate
$100 Advanced $200 SE Practitioner
Donations
$25 $50 $100
$200 other
Photo
Are you submitting a picture?
Yes
If so, email photo in a jpeg format to info@traumahealing.com

There will be a 10 dollar scanning fee if mailed to FHE.
No
Use Existing Photo

PAYMENTS
Payments in US Funds only. Please submit the appropriate payment to the FHE within 3 days.

Mail:
Foundation for Human Enrichment
7102 La Vista Place, Suite 200
Niwot, CO 80503

Credit Card by Phone: 303-652-4035

Credit Card by Fax: 303-652-4039