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Application Form

Please use this form to begin your registration for the course. For Rosen workshops, this form completes your registration. For Rosen training programs, an interview is the next step.

Application Form
All information provided will remain confidential.
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First Name *
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Cell Phone Number
(123) 456-7890
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Home Phone Number
(123) 456-7890
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Email *
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About You
Please answer the following questions.
Previous Experience *
What is your previous experience with Rosen Method?
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Professional Background *
What is your professional background in the health professions, movement, or related fields?
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Personal Experience *
What is your personal experience with other forms of bodywork of movement?
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Purpose *
What is your purpose in taking this Rosen Method program?
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Course Information
Course Title *
Which course are you registering for?
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Course Dates *
Please list the start and end date(s) for the course you are registering for.
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