Application Form
Bruxelles 5 · Brussels
Please complete this form to apply for the professional training programme.
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Personal information
Step 1 of 5
Title
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Mrs
Mr
Prefer not to say
Full name
*
Email address
*
Date of birth
*
Nationality
*
Phone number
*
Postal address
*
Preferred pronouns
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Background & motivation
Step 2 of 5
What is your profession?
What are your qualifications / diplomas?
Can you share a few lines about your background?
What is your experience with the Feldenkrais Method? (workshops, classes, FI)
What is your motivation for this training?
*
Why did you choose this training over another?
Do you have any health conditions you would like to share?
Is there anything else you would like to share about yourself?
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How did you hear about us?
Step 3 of 5
Source
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My practitioner
A friend
Family
Brochure
Search engine
YouTube video
Other
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Logistics
Step 4 of 5
Have you already arranged financial support?
Yes
No
I would like more information
Have you already arranged transport?
Yes
No
I would like more information
Have you already found accommodation?
Yes
No
I would like more information
Will you be available for the training segments?
Yes
No
I would like more information
Have you reviewed the training programme?
Yes
No
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Consent
Step 5 of 5
Your personal data is collected as part of your professional training application. Under GDPR, you have the right to access, rectify and delete your data.
I consent to the processing of my personal data for the purpose of my training application.
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Submit my application