DTAP Treatment Approach Training Application

DTAP® Certification Program

2026 Cohort Application
Personal Information
Name*

First NameLast Name
Address*

Street Address

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Email*
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Phone Number*
Please enter a valid phone number.
Professional Background
Current Job Title*
Organization (if applicable)*
Field of Study*
Years of Experience in the Field*
Highest Degree Earned*
Motivation and Goals
Why are you interested in the DTAP program?*
What specific skills or knowledge do you hope to gain?*
Please describe your trauma and attachment knowledge.*
What other modalities do you and/or your agency implement?*
Expectations

Are you able to commit to the necessary time and effort to complete this training program?
Participate in pre-work readings, webinars, etc.*

YesNoNot Sure
Attend training sessions and complete assignments to prepare.*

YesNoNot Sure
Participate in monthly consultation for six months.*

YesNoNot Sure
Additional Information
Please provide any additional information or comments.
How did you hear about us?

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I understand that for full certification, I am required to attend all training modules and follow up consultations.*

I accept the terms and conditions.
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Date signed*

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DTAP® Certification Program