Application Form – Spirit of Learning® | Professional Development from Body Therapy Institute and The Center for Embodied Education

NOTE: all fields are required

Your Full Legal Name*

First Name Last Name

Preferred Name*

Address*

Mailing Address City State Zipcode

Email*

Enter Email Confirm Email

Phone*

This phone is:*

Cell
Home
Work

Gender Pronoun*

she/her/hers
he/him/his
they/them/theirs

Date of Birth*

Let your answers to the following questions be thorough:

1) EDUCATIONAL BACKGROUND: List all institutions you attended following high school, and the type of academic or professional credential earned. Include significant professional training programs and areas of current study.*

2) Describe your professional background, including your current job/position and areas of responsibility.*

3) What strengths and resources do your bring to this training process?*

4) Describe why you want to enroll in The Spirit of Learning and what you hope to gain from it, both professionally and personally.*

Your completed application will be reviewed by the Director, and you will be notified within two weeks about your admission into The Spirit of Learning®.

The Application Fee is $25.00, which you will pay here with your PayPal account (OR) a Debit or Credit Card after clicking the SUBMIT button at the bottom of this form. You do NOT need to have a PayPal account to complete this process.

If you have a PayPal account:
• Enter your password in the next screen, then click the blue "Log In" button.
• On the next screen, verify your payment source and click the blue "Pay Now" button.

If you don't have a PayPal account:
• Click the gray button on the screen to "Pay with a Debit or Credit Card".
• On the next screen for "Guest Checkout", enter your payment info and click the blue "Pay Now" button at the end.

You'll receive payment confirmation via email.

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I'm paying the Application Fee by:*

PayPal Account; Debit Card or Credit Card

Spirit of Learning Application Fee: Online Payment*

Price:

Body Therapy Institute
PO Box 1801, Pittsboro, NC 27312
Email: info@bti.edu