Berkeley Center: Application Form
In order to apply for a Berkeley Center event, please fill out the below form and we will get back to you shortly with next steps. If you have any questions please contact: info@rosenmethod.com
What event are you applying for?
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In-person Movement Intensive April 8-12
Spring Bodywork Intensive May 3-8
Autumn Residential Intensive Sep 13-20
Online Movement Intensive - Sep 26-28
Weekly Bodywork Class - Start Oct 13
Rosen Movement Intensive - Oct 21 - 25
Are you applying as a:
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Current or Past student
New (Prospective) student
Reviewer (interns or certified practitioner or movement teacher pursuing continuing education)
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Current and Past Students
Please fill in the following details and we will get back to you shortly to continue the registration process.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone
Has your address changed in the last year?
Yes
No
Emergency Contact: Name and Number
*
Would you like to apply for a scholarship for this event?
Yes
No
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New Students
Please fill in the following details and we will get back to you about next steps.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you have a different mailing address?
Yes
No
Occupation
*
What is your previous experience with Rosen Method? How did you hear about the Berkeley Center?
*
Please describe any experience you have with the professional health, movement or related fields.
*
What is your personal experience with other forms of bodywork or movement?
*
Tell us a little about why you would like to take this Rosen Method course or training program.
*
Are you interested in learning more about our scholarship opportunities?
Yes
No
Emergency Contact: Name and Phone number
*
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Reviewers
Please fill in the following details and we will contact you with more information
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone
*
When was the last Rosen event (intensive, continuing education, etc.) you attended?
Date
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Thank you for your responses. Please click SUBMIT
And we will get back to you shortly
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