Masters Series Application
Complete and submit this application to hold your place for this Training. As Barry Jenings will personally be contacting you for an Interview, please be sure to complete the best time to call section. Please print clearly. We look forward to seeing you in class!
 
Training City
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Name
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Mailing Address 1
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Address 2
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City
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Postal Code / Zip Code
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Email Address (*)
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Confirm Email Address (*)
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Phone Number (Office)
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Phone Number (Home)
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Phone Number (Cell)
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Best Time to Call (days and times)
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Education and Experience (Please lsit, with most recent first)
Formal Education (*)
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Years, Clinical Practice: (*)
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Practice Focus (*)
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Workshops/CEUs Taken
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Please answer the following questions: (Spend some time! Try to avoid limiting beliefs or statements. Be honest with yourself!)
1. What interests you about The Master's Series Training?
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2. What are your goals for this training?
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3. What do you consider your strengths?
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4. What challenges you as a therapist?
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5. Describe your dream practice/clinic/career, your income.
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6. What truly stops you from achieving this?
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Thank you for completing our application. Click to submit. You will be contacted for your interview.

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