Applications

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Applications 2017-09-04T15:47:00+00:00

Application:

Registration is open now.

To register for the Course, please call Judith Johnson to let her know of your interest and send in the application (see below) by providing answers to the following questions.

Send the file to JudithAJohnson@mac.com, or send it by mail to 329 Eden Dr., Hillsborough, NC, 27278.

In addition, note that there is a $100 registration fee, due with the application.

Application

Contact Information
Name:
Birthdate:
City, State & Zip:
Phone, Skype, etc:
E-mail:

Basic Résumé
Occupation
Education
Family

Previous Experience with PNE or Other Healing Modalities
Which practitioners have you worked with?
How many sessions have you had?
Which other types of therapies have you been involved with, as a client or practitioner?
Are you living some version of a regenerative lifestyle? (Please answer in detail.)

Medical Issues
Do you have any active addictions that you’re struggling with?

Are you taking anti-depressants or other prescription medications?

Are you seeing a counselor or mental health professional on a regular basis?

Goals
What are your goals for the Practitioner Training Course?

Why do you want to pursue this training?

Is there any information that is important for us to know about you that could affect your participation in this training?

Judith Johnson, (919) 245-8082 (home), (828) 773-3445 (cell), judithajohnson@mac.com

Sieglinde Hieronymus, +49 8368 266 434, sieglinde.hieronymus@gmx.de