MBCT Training Application Form

MBCT Training Month and Year that you are applying for. Please select one from the list below.*
Name*
First Last
Email*
Country of Residence*
State/Province/Region*
1. Do you have a degree? If so, in what field/discipline.
2. Please describe your professional training and experience in psychotherapy.*
3. Do you have a regular meditation practice? Please state the tradition, describe number of times a week you practice, the typical length of each session, and number of years you have been practicing. Please describe in 50 words or less.*
4. Please list teacher-led silent mindfulness meditation retreats that you have completed. List dates, location and teacher's name.*
5. Please explain why you want to take this MBCT training in 200 words or less.*