C1 Somatic Experiencing Rishikesh Training- Registration Form

Welcome! To participate in the Intermediate 1 Somatic Experiencing Seminar, you must have successfully completed your Beginner’s Year. This requirement ensures you have the foundational knowledge necessary to fully benefit from this next step in your SE journey.

Prerequisite Details:
• If you attended a 6-day Beginner’s Year format, please upload certificates for both seminars (Modules 1 and 2).
• If you attended a 3-seminar Beginner’s Year format, please upload certificates for all three seminars.

This information will help us review your application promptly. Once we have verified your prerequisites, we will get back to you regarding your registration status.

Thank you, and we look forward to having you join us on this next step of your SE training!

The dates for the training for Cohort 1 will be as follows-

Cohort 1 Dates-

Beginner 1: 26th Mar 2024 – 31st Mar 2024
Beginner 2: 12th Nov 2024 – 17th Nov 2024

Intermediate 1: 1st Apr 2025 – 6th Apr 2025
Intermediate 2: 28th Oct 2025- 2nd Nov 2025

Advanced 1: 3rd Mar 2026 – 8th Mar 2026
Advanced 2: 22nd Nov 2026 – 27th Nov 2026

We would like you to know that submitting this does not confirm your participation as a student.
Please reach to us at pooja@thewhiteelephant.in or +91 9731819703 if you do not hear back from us within 3 working days.

For international participants, we recommend that you apply for an entry Visa ( as recommended by the Indian Embassy ) to attend training such as ours. We do not take responsibility for the Visa process, but definitely support you with an invitation letter for the same.
For more information on the training, please refer to the PDF on the website.
Click here for more details
Thank you.

Name (As per your Passport or ID proof)*

Name (You want on the certificate)*

Contact No. (Preferably WhatsApp)*

Email Id (This will be used for official communication with The White Elephant team)*

Have you finished the modules of the Beginner Year?*

YesNo

Please Upload the Beginner Year Certificates*

Gender*

MaleFemaleOther

How would you liked to be addressed He/Him, She/Her, They/Them?*

Date of Birth*

Date

Nationality*

Where are you currently located or based out of?*

Address*

A little about your Current Practice*

A professional Image of your's*

ID Proof*

Emergency Contact & Relationship*

Have you attended any workshops or trainings of Somatic Experiencing before?*

YesNoMaybe

Are you currently enrolled in any other training or certification program? If yes, Please provide us with the details. *

Please describe any previous training or experience you have related to Somatic Experiencing or other therapeutic modalities:*

Do you have any physical or medical conditions that might affect your participation in the training? If yes, please provide details. *

How did you hear about this Somatic Experience training program in Rishikesh?*

Highest Degree Attained ( Name of University )*

You are informed about the NO REFUND POLICY? ( If lockdown situation, we do not prefer continuing the training online, we intend to wait for a later date to do in person)*

YesNo

Resume Attachment*

Write a little about yourself and your intention about learning Somatic Experiencing? *

Do you plan/intend to complete the 3 year training in Rishikesh with us?*

Somatic Experiencing Rishikesh Cohort 1- Intermediate Year Registration Form