This application is to be shown to and signed by the student's EI Trainer after completion of all requirements. The applicant then sends the application, items and fee directly to the ICRI in Mill Valley.
I have completed - the following requirements from International Council of PsychoCorporal Trainers (ICPIT) and the International Centre for Release and Integration (ICRI) :
[_] Minimum of 700 hours of training in three phases over 3 years.
[_] Worked with the simultaneous unity of energetic, emotional, cognitive and physical dimensions of bodymind.
[_] Internship, consisting of work with three training-clients, including supervision.
[_] Completed a ten page report of working with training-clients in Phase III and have presented a copy of the report to my trainer before his/her signing below..
[_] I am enclosing one copy of my report for ICRI.
[_] I understand that it is my responsibility to obtain the necessary licence
for practising EI in my country.
[_] I have completed any additional requirements from my PI Trainer and understand that the requirements from ICRI and ICPIT are separate from the ones my trainer may state additionally.
[_] I am sending an International Postal Money Order, or a countersigned Traveller Cheque, paid to the order of Jack Painter, for $125.00
(other forms of checks cannot be accepted).
[_] I understand that my diploma will be issued by The International Center
for Release and Integration (ICRI) and The International Council of PsychoCorporal Integration Trainers (ICPIT) and will be signed and awarded to me by my trainer.
Name of Applicant's Trainer ...................................................
Signature of Applicant's Trainer ...................................................
Applicant's Name ............................................................................
Address ........................................................................................
........................................................................................
........................................................................................
Phone/Fax ................................................ E-mail.............................................
Signature........................................................ Date..............................
