Transpersonal Hypnotherapy and Regression Therapy Training Admission Form

Transpersonal Hypnotherapy and Regression Therapy Training Admission Form

Please complete the form accurately and thoroughly. All information provided will be kept confidential.
Email*
example@example.com
Full Name*

First NameLast Name
Date of Birth*

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Date
ID/ Passport Number (We request your ID/ passport number solely for invoicing and compliance purposes. In certain cases, official identification details are required to accurately issue an invoice and ensure it meets administrative or regulatory requirements. Your passport number will be used only for this purpose and handled securely in accordance with applicable data protection laws.)*
Gender*
Address*
City
State/Province*
Zip/Postal Code*
Country*
Email Address
example@example.com
Phone Number (including the Country Code)*
Please enter a valid phone number.Format: (000) 000-0000.
Highest Level of Education Completed*
Name of School/College/University*
Field of Study*
Year of Graduation*
Current Occupation*
Relevant Work Experience (if any)
Please briefly explain why you are interested in pursuing training in hypnotherapy and regression therapy*
Have you received any previous training or experience in hypnotherapy or regression therapy?*
If yes, please provide details
Do you have any physical or mental health conditions that may affect your participation in the training program?*
If yes, please provide details
What are your expectations from this training program?*
Training Readiness Questionnaire
Please complete thie fields below to help us assess your readiness for intensive professional training in transpersonal hypnotherapy and regression therapy.
Briefly describe your current professional background.*
Describe the personal and professional support you currently have in place (e.g., individual therapy, supervision, peer groups, spiritual direction, trusted relationships). For each, say how long you've been engaged and how often you meet. If you don't currently have individual therapy, briefly explain why.
Think of a time when someone in a teaching or mentoring role didn't meet your expectations or handled something in a way that didn't sit well with you. What happened, and how did you navigate that, in yourself and with them?*
In any learning environment, there are moments when a rule, boundary, or decision set by an instructor or supervisor doesn't quite sit right. Think of a time when this happened to you. What was going on internally, and how did you handle it?*
This training can bring up deep personal material, that's part of how it works. With that in mind, is there anything in your life right now that might benefit from having individual professional support alongside the training? This could include therapy, supervision, or any other form of one-to-one care. If you already have something in place, let us know. If not, that's okay, we'd simply like to understand where you are.*
Imagine you're in a training exercise and something personally intense is activated, like grief, anger, shame, old family material. Walk us through what you would realistically do. What happens in the moment? And once the exercise is over, in the hours or days that follow, how do you tend to take care of yourself?*
When there was stress or tension in your early family, what did you tend to do? Describe the role you fell into naturally, then, if one of these labels fits, select it:*
Describe in detail your experience when there was stress or tension in your early family, including your natural role.*
If you selected a role above, briefly share one memory that illustrates this role in action.*
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
What are you most hoping this training will provide you at this stage of your life? What would make participation feel successful for you?*
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Transpersonal Hypnotherapy and Regression Therapy Training Admission Form

Training Readiness Questionnaire