CPAT - NZ Application Form

Please read this website before submitting an application: https://cpat.mindmedicineaustralia.org*

I have read the eligibility requirements
1. Personal Details
Full Name*

First NameLast Name
Birth Date*

DayMonthYear
Date
Current Address*

Street Address

CityState / Province

Postal / Zip Code
Please note that this address is used to mail out course materials. Please ensure it is a correct and complete mailing address.
Phone Number*
International applicants please ensure you include country code: e.g. +64, +1, +44 etc
Email Address*
example@example.com
Occupation*
Company / Organisation / Self*
Gender
2. Qualifications & Background
Degree Qualifications (Please include dates)*
Did this include specific training in mental health?*

YesNo
Details of any other training in mental health / psychological therapy
Details of any other specialist knowledge/experience you regard as relevant to this application
Type of Professional Registration Number*

MCNZNZPBOther
Professional Registration Number:*
History of Practice:

Direct one-to-one hours providing counselling or psychological interventions
Please List Positions and Dates Held
Do you have experience working with people with difficulties related to:

DepressionAnxietyPTSDSexual TraumaAddiction
4. Additional Information to Support your Application
Your knowledge and experience in the field of psychedelic medicines (You are not required to disclose personal use or any practices that are currently illegal)
Personal development and contemplative practices are often considered essential for development as a psychedelic-assisted therapist. Please provide some detail of what you do for personal cultivation. E.g.: meditation, breathwork etc.
Why do you want to do this course?
Where would you ideally like to apply this knowledge?
Any other information to support your application
First Professional Reference
Title:*
Name*

First NameLast Name
Role:*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Relationship to you:*
Second professional reference from your supervisor or employer:
Title:*
Name*

First NameLast Name
Role:*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Relationship to you*
ONE personal reference:
Title:*
Name*

First NameLast Name
Role:*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Relationship to you:*
5. Financial Assistance
Financial Assistance*

I am not applying for a financial assistanceI am applying for financial assistance
MMA's CPAT has limited places available with financial assistance (FA). FA is granted for those who demonstrate excellence, need and commitment. Additional assistance is available for those from rural, regional areas and/or those from indigenous or other diverse groups.
Please tell us a little bit about what makes you an excellent practitioner in your field.
Please tell us about why you need financial assistance.
Please tell us about your commitment to the future of psychedelic-assisted therapies and helping others.
Please select any of the below that apply for you:

Live/work in a regional areaIndigenous heritageWork with vulnerable populations
Various amounts of financial assistance are available. The maximum assistance is a reduction of half the course fees. Keeping in mind that funds for financial assistance are limited, and we aim to support as many practitioners as possible, please enter below the amount of financial assistance you feel you will require to make the course affordable.
Please share any additional comments you wish to support your application for financial assistance
6. Course Requirements

Please see and read the terms here: https://cpat.mindmedicineaustralia.org
Terms and Conditions

I agree to the course terms and conditions
Student Code of Conduct

I agree to the course student code of conduct
6. Course date options
Upcoming CPAT course dates are as follows:

2025 Cohort 1: Feb 16 -June 22
Sydney residential: June 2-7
Melbourne residential: June 10-15

2025 Cohort 2: July 27 - Nov 16
Sydney residential: October 27 – November 1
Melbourne residential: November 5 – November 10
2025 Cohort 1: Feb-June2025 Cohort 2: July-November
Please select your preferred cohort:

2025 Cohort 1: Feb-June2025 Cohort 2: July-Nov
Please select your preferred intensive:

MelbourneSydneyOpen to eitherNot yet certain
7. How did you hear about CPAT?
Please select one:

Psychedelic Training NZSearch EngineGoogle AdsLinkedinFacebook AdsFacebook post/groupOther social mediaMMA Fundamentals Online CourseBlog / publication or articleEmail newsletterWord of mouthOther
8. Payment
The course fee for MMA's CPAT is $10,950 AUD. This can be paid in 3 instalments.

A $1000 fee reduction is applicable for students who choose to pay the entire course fee upfront.

In addition to the course fee, there is a non-refundable $250 application fee. Applicants applying through Psychedelic Training New Zealand are eligible for a reduced application fee of $50 NZD. Upon completion of this form you will be taken to PayPal to pay this application fee.

Once you have been accepted into the course we will issue you an invoice for the course fee.

CPAT Application Fee

$50.00NZD

Enter coupon

Total

$0.00NZD

What is your preferred payment option:*

1 x $9,950 AUD3 x $3,650 AUD
What is your preferred payment option:*

1 upfront payment3 separate payments
Next Steps & Confirmation of receipt

When you press the Submit Application below you will be redirectied to PayPal to process the $50 NZD application fee.

A member of MMA's CPAT team will be in contact within 3 business days to confirm receipt of your application and to arrange your application interview. Please contact cpat@mindmedicineaustralia.org with any questions you have.
Unable to Process Payment

If you are unable to complete payment of the application fee via PayPal for any reason, please email cpat@mindmedicineaustralia.org. Once you click "Submit Application" we will have your application saved and can process your application fee manually if required.

Saving Form

Below you can click "Save" to save progress on your application if you are not yet ready to submit. After you click save:
- Scroll up the form, where you'll see a pop up box that says "Sign up to save submission as a draft"
- At the bottom of the pop up box, click the link "Skip Create an Account"
- Enter your email address and click "Send"
Applied for FA

YesNo
Should be Empty:

1. Personal Details

2. Qualifications & Background

History of Practice:

4. Additional Information to Support your Application

First Professional Reference

Second professional reference from your supervisor or employer:

ONE personal reference:

5. Financial Assistance

6. Course Requirements

6. Course date options

7. How did you hear about CPAT?

8. Payment