POSBAM Application Form 2022

Full-Presence 8-Week Meditation Course 2022 Application Form

Learn Full-Presence Meditation® with HELENE GALLAGHER
Inscriptions are open for the following course: POSBAM w/ Helene Gallagher
Please answer the following questions in full detail. This is for your own clarification and alignment for your process and provides us with valuable information. The information you provide on this form will be treated fully confidentially.

This course is for individuals who wish to:
- familiarize themselves with meditation, learn to meditate & learn from their meditation experience
- strenghten their self-esteem
- better manage anxiety
- develop their benevolence
This program features the following :
- Offer yourself 40 minutes per day for 8 weeks
- Discover the pleasure of regular daily practice
- Become self reliant in the practice of Full-Presence Meditation®
- Receive live mentoring through 8x 90-minute live virtual group sessions, 1 x week
- Get continuous one-on-one support with your facilitator
- Let yourself be carried by the progressive levels of guided meditation recordings and movement exercises
- Access educational videos to better understand Full-Presence Meditation®
- Intregrate each meditation by repeating it for 3 consecutive days
- Evaluate your progress by journaling your experience
- Enjoy being accompanied with benevolence and efficacy
Maximum number of participants: 12

Dates: September 7th - October 26th, 2022

Pre-Course Orientation Evening: Tuesday August 30th, 2022, 19:30- 20:30pm CET

Mentoring-& Support Group Sessions: September 7th, 14th, 21st, 28th; October 5th, 12th, 19th, 26th (Every Wednesday Evening at 19:30- 21pm CET)

Closing Session: Tuesday November 1st, 2022, 19:30- 21pm CET

Location: Online

Price for the 10 sessions + all learning material + Certification: 215,- Euro

Supported Rate 180,- Euro (for people with low incomes)

Supporting Rate 250,- Euro (for people who would like to support individuals with low incomes)

The POSBAM training is a structural educational process in Full-Presence Meditation®. In order to ensure this course is right for you at this time, please complete the following application form. We will contact you directly on receiving the form to confirm your place.
Name *

First Name Last Name
E-mail *
Phone
1. MEDITATION PRACTICE
1.1 Have you had any previous experience with meditation techniques, therapies, healing or awareness practices? If yes, please specify details below (what kind of practice, for how long, how did you discover it? etc). If this is your first contact with meditation practices, please go further with question 1.6. *
1.2 How often do you meditate?

I used to practice, but don't practice anymore Once a month Once a week Everyday
1.3 In what frequency do you meditate?

regularly often occasionally almost never
1.4 What is the average duration of your meditation?
1.5 Do you teach others/ facilitate groups? If yes, please describe details.
1.6 Do you employ currently body practices such as exercising, yoga, walking, running, qi gong, tai chi etc.? Specify how long and with what frequency you are practicing: *
2. MOTIVATION

What makes you want to participate in this 8-week meditation course?
2.1 What is motivating you to participate in this 8-week meditation course? Please describe your interests, your expectations, your personal and/ or professional motivations. *
2.2 What do you wish to learn from this course? Please list at least three things. Which personal/ professional/ philosophical or spiritual questions would you like to address within this trajectory? *
Check the areas of most interest to you

Increase Performance Breathing techniques Bodily Alignment Strengthening Self-Esteem Reduce Anxiety Philosophy Anatomy/ Physiology Meditation technique Develop Benevolence Renew the Relationship with myself and others Create a space for deep rest Discover something new
2.3 What training or experience in your background might serve you as a participant?
3. OVERALL HEALTH AND WELL-BEING

Please indicate which one of the options below best describes your current state of health.
3.1 How is your overall state of health and well-being? *
3.2 I am in good general health, and generally cope well with daily physical and mental challenges:

yes
or
I would like to mention the following physical and/ or mental challenges, I struggle to cope with at this point:

3.3 How would you rate your current stress level from 1-5? (1 being low and 5 being high level of stress)

	1	2	3	4	5

1 is low, 5 is high

3.4 How would you rate your current ability to cope with this stress? (1 being low and 5 being high level of stress)

	1	2	3	4	5

1 is low, 5 is high

4. PRACTICALITIES
Do you have an apparatus to listen to an mp3 recording e.g. SmartPhone / laptop? *
Will you be attending the online pre-course orientation evening? *
Fees & Availabilities - Please choose the option applying to you *

Supporting Rate - for those with low incomes €180.00 (incl. 21% BTW) Standard Rate - pays facilitator and OMC costs €215.00 (incl. 21% BTW) Supporting Rate - supports others to attend who are on low incomes €230.00 (incl. 21% BTW)
Full-Presence Meditation® Code of Conduct
How did you hear about this course? *

Friend/Colleague Research Social media
Please enter the letters you see below *
Please inscribe me for the POSBAM 8-Week Meditation course. *

Yes
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Full-Presence 8-Week Meditation Course 2022 Application Form