EMHA FREE Foundation Weekend Online 2023 Application

FREE Foundation Weekend Application, Saturday 3rd and Sunday 4th June 2023

Complete the form below to APPLY for your FREE PLACE.
NAME:*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
MOBILE NUMBER:*
please include international code
ARE YOU AVAILABLE ON WHATSAPP WITH THIS NUMBER?*

YesNo
E-MAIL ADDRESS:*

Confirmation Email
AGE:*
CURRENT OCCUPATION (previous if retired):*
NATIONALITY:*
DO YOU SPEAK AND READ FLUENT ENGLISH?*

YES
HOW DID YOU HEAR ABOUT EVOLVE MINDS?*
HAVE YOU TRAINED IN HYPNOTHERAPY BEFORE?*

YESNO
DO YOU HAVE ANY MENTAL HEALTH ISSUES THAT YOU ARE CURRENTLY AWARE OF?*

YESNO
PLEASE TELL US WHY YOU WOULD LIKE TO BE CONSIDERED FOR A FREE PLACE:*
ARE YOU AVAILABLE TO JOIN US FOR THE WHOLE WEEKEND, SATURDAY 3rd & SUNDAY 4th June 2023*

YESNO
Should be Empty:

FREE Foundation Weekend Application, Saturday 3rd and Sunday 4th June 2023