WORKSHOP REGISTRATION FORM Email * Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Primary * (###) ### #### Secondary (###) ### #### Age Sex/gender with which you most closely identify * Prefer not to answer Male Female Race American Indian/Alaska Native Asian Black/African American Hispanic/Latino/Spanish Native Hawaiian/Other Pacific Islander White Two or more races Prefer not to answer Highest Level of Education * High school diploma Some college Associate's Bachelor's Master's Doctorate Business/Organization Position Occupation * Business Owner Coaching Counseling Education Human Resources Law Management/Administration Medicine Nursing Organizational Consulting Psychology Religion/Ministerial/Clergy Social Work Other If other, please describe Continuing education (CE) you are seeking * None Counselor Social Work OPA-MCE (Ohio Psychologists Only) APA (Non-Ohio Psychologists) License # If you are seeking continuing education (CE), please enter your license number. Please share any accommodations you require (e.g., ASL interpreter, service animal, ramp-accessible parking). Featured A Gestalt Approach to Working with Groups and Teams, Module 2 (PROGRAM TEMPLATE) Hidden Figures: Helping couples discover underlying patterns in their communication A Gestalt Approach to Working with Groups and Teams, Module 1 Gestalt Institute Leadership Development (GILD) Writing Better: Enriching Your Writing Process Neuroscience and the Art of Gestalt: Enhancing Relational Effectiveness Men's GEW - Gestalt Experience Workshop Creative Expression: Going Deeper with Your Coaching Clients The POWER of Resistance: A Gestalt Approach Hidden Figures: Helping couples discover underlying patterns in their communication. Re-creating Personal Financial Confident, by re-imagining your relationship with money in a field-collaborative way Overcoming Imposter Syndrome: A coach-approach to unlocking the power of Alter Egos The Art & Science of Team Coaching Atmospheres of Illness, Death and Dying: An Immersion in Supporting Life Transition sold out GEW - Gestalt Experience Workshop, May 2025 Introduction to Gestalt Embodied Intelligence and Presence: A Gestalt Approach to Coming to Your Senses Wisdom Gathering: Let Your Life Speak and Be There to Listen Sensing & Repatterning 3.0: An Embodied Approach to Working with Introjects Integrating Gestalt Therapy and EMDR Coach Certification Program - Application Fee sold out Gestalt Training Program XXIV (GTP) Holding Sorrow and Joy: A Conversation about Grief/Depression sold out Coaching with Physical Process 2.0 A Gestalt Approach to Working with Groups and Teams, Module 2 sold out The Embodiment of Co-Transference: Shame and Coregulation in Gestalt Therapy
