Application Form
Oral Story Based Trauma Healing
Please tick off the latest Certification Level you have in Trauma Healing:
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Apprentice facilitator
Training Facilitator
Master Facilitator in-training
Master Facilitator
Have you done your Trauma Healing certification in ALICT
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YES
NO
If you haven't done your Trauma Healing certification in ALICT; please tell us where have you done it and when? (Country and year)
If you haven't done your certification in ALICT, please upload your certification
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Your Name
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First Name
Last Name
In which year have you done ALICT?
Gender
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Male
Female
Phone Number
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Format: (000) 000-0000.
Email Address
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example@example.com
Please tell us how this Equiping session will serve you and the work you do (max. 200 words)
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Do you commit to fully attend and be on time for each session? Dates: Tuesday 14, Wednesday 15, Thursday 16 May and Tuesday 21, Wednesday 22, Thursday 23 May 2024Time: 11 - 13h30 SA time (Approximately 2 to 2h30 min per session)
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Yes I do
I am not sure
Are you able to meet on Zoom?
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Yes I do
I am not sure
Any additional comments or information you would like to share? (max. 200 words)
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