Trainee Registration - Brainspotting Philippines Training Consultancy Services

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Trainee Account Registration Form

Personal Information

Full Name

Area of Specialization (e.g., Clinical, Forensic, Addiction, Trauma, Neurodevelopmental , etc.):

Years of Practice:

Work Address:

Professional License (if applicable):

Highest Educational Attainment and Program completed (e.g., MA in Psychology):

Institution Attended:

Contact and Security Details

Email address:

Password

Mobile Phone Number:

Upload photo (preferably with white background)

Resume Attachment (Pdf Only)

Brainspotting Training Background (Select No if you have not completed the training)

Phase One:

Yes

Date of training:

Training Facilitator:

Phase Two:

Yes

Date of training:

Training Facilitator:

Phase Three:

Yes

Date of training:

Training Facilitator:

Phase Four:

Yes

Date of training:

Training Facilitator:

Master Class:

Yes

Date of training:

Training Facilitator:

Kindly state your reason/s in joining the Brainspotting Training: (Optional)

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Brainspotting PH

an organization dedicated to developing a professional community to help expand the understanding of Brainspotting and supporting people in making life-changing breakthroughs

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0920 240 5580

0932 314 1994