Application

Thank you for your interest in the Gestalt Equine Institute of the Rockies. For a quicker response, please fill out all the fields below to the best of your ability.

Please note, within the application is a request for a 2-4 page autobiography about yourself, including information about you and how that links to your interest in Gestalt Therapy training. You can attach a typed document within the application.

If you have questions or problems with the application, please contact Kimberly at gestaltequine@gmail.com.

Thank you!!

GEIR Application

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

Why are you interested in attending the Gestalt Equine Institute of the Rockies? *

Briefly describe your past horse experience? *

On a scale of 0-5 (0 being very uncomfortalbe/afraid), what is your comfort level around horses in general? *

Have you ever experienced emotional or physical trauma in your life? Share, in general, in a few statements. *

What do you hope to gain from this training? *

Do you have any physical or personal needs we should be aware of that may impact your experience with us? *

Do you feel nervous or concerned about participating in this training program? If so, about what? *

Please list any earned academic degrees (Majors studied, where they are from, dates). *

Please list any previous (or current) post-graduate or special trainings that relate to fields of psychology or equine studies. *

What is your current or recent professional work experience? *

Name and contact number for professional reference. *

Name and contact number for personal reference. *

Please upload a 2-4 page autobiography including information about yourself and your interest in GEIR. *

Max file size: 20MB

The above information is true and complete to the best of my knowledge. The Institute has my permission to obtain all necessary information from the references and training institutions I have listed concerning my past experience and I release all parties from any possible damages resulting from disclosing such information with or without prior written notice from me. I understand that this application does not constitute a contract of any kind, and does not indicate acceptance into the program. Should the Institute enroll me and I attend the modules, I may terminate such enrollment at any time and understand that the Institute will retain all monies paid thus far.

Printed signature confirming that you understand the above information. *

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Application

GEIR Application

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Application

GEIR Application

Location

What Our Clients Are Saying

Contact Us

Subscribe Today!