Diploma in Teaching Mindfulness & Positive Psychology Enrolment

Mindfulness Teacher Training Application Form
Diploma in Teaching Mindfulness & Positive Psychology
Please fill out this form in a detailed manner. Should you choose to enrol in the course, the information you provide in this form will be used, in part, to decide whether or not we can offer you a place on the training programme.
Name*

First NameLast Name
Address*

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Mobile Phone Number*
E-mail*
Please answer the following questions
What is your current profession?*
What is your current position and what does your day to day work entail?*
What training have you done, including academic study, diploma and certification programmes?*
What certifications, diplomas, degrees, etc. did you receive (please list with dates )?*
Are you familiar with MBSR or MBCT, either through reading about them or practicing them yourself?*
Have you taken part on an 8-week course in MBSR and/or MBCT? If so please provide dates and an overview of the course, provide the name of the teacher and the location.*
What Mindfulness books have you read?*
Do you currently teach MBSR or MBCT? If YES how many MBSR or MBCT courses have you taught and when?*
Do you currently offer Mindfulness as an approach where you work? If so please give details.*
Do you currently have a mindfulness practice? If so, how many years have you been practicing mindfulness?*
How regular is your mindfulness practice? (e.g. please state how many times you practice per week)*
Retreat participation - please list any retreats, and the number of days duration, you may have participated in.*
Why do you want to teach Mindfulness?*
Please describe your Mindfulness practice and the role it has played in your life.*
Where did you hear about us?*

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Carmel Farnan
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Mindfulness Teacher Training Application Form

Diploma in Teaching Mindfulness & Positive Psychology

Please answer the following questions