Teach .breathe Application

Please select the Teach .breathe course you are applying for*

Please select a course from the drop down menu before proceeding with your application.

Read the delivering .breathe Terms and Conditions

Read the MiSP one-day course Terms and Conditions

Terms and Conditions

I have read, understand and fully agree to the Terms and Conditions and prerequisites for taking part in this training course and confirm that I meet these prerequisites and agree to the ongoing commitments as a .breathe teacher as described.

Please confirm you have read the Terms & Conditions for delivering .breathe.*

I have read the Terms & Conditions for delivering .breathe.

Please confirm you have read the MiSP one-day course Terms & Conditions.*

I have read the MiSP one-day course Terms & Conditions.

Please confirm that you have read the .breathe prerequisites.*

I have read the .breathe prerequisites.

Your Details:

Name (First name and Surname. This will be the name used on your certificate)*

Email address for course communication*

Please check you have typed this correctly.

House number or name*

Street*

Town or City*

County or state*

Postcode*

Country*

Region*

Home telephone number (please include country code if outside the UK)*

Mobile telephone number (please include country code if outside the UK)*

Emergency Contact while on the course:

Please give details of an emergency contact who will be available while you are on the course.

Name*

Number (Landline)*

Number (Mobile)*

Your Employment:

Your Profession*

Your Employer*

Your Employer's Postcode*

Is your employer*

A maintained school (incl. grammar school) or academy chain in the UK
An independent school in the UK
A council, LEA or other governmental body
A non-UK school or other international educational body
Other (please specify)
I am self-employed

Please specify*

Name of school or place of work*

Postcode of school or place of work*

Funding:

How is your attendance being funded?*

Self-funded
MISP supported place
Other

To secure a place payment is due within 2 days of receiving the invoice. If you are applying for a Private Group place, you will not be invoiced.

To secure a place payment is due within 2 weeks of receiving the invoice. If you are applying for a Private Group place, you will not be invoiced.

To secure a place payment is due within 2 weeks of receiving the invoice. If you are applying for a Private Group funded place, you will not be invoiced.

Enter the code received from MiSP*

Organisation name*

Organisation address*

Contact name*

Contact email address*

Please provide the name and address of the organisation and the contact name and email address of the person we should send the invoice to:

Other Information:

Please confirm you are over 18 years of age*

I confirm that I am over 18 years of age

Please confirm your level of English*

I confirm that I am able to speak and understand English to an Upper Intermediate Level, i.e. I am able to interact fluently with native speakers, communicate effectively and understand everyday language without the aid of an interpreter.

While this course is very much an introduction to mindfulness, there will periods during the day when we engage in brief mindfulness practices. If there are any aspects of your life, e.g. recent mental health issues, trauma or major life events, that you feel may affect your participation in, or experience of, the course please do let us know by contacting support@mindfulnessinschools.org. Please be assured that any personal information you disclose will be treated in the strictest confidence.

Do you have any physical illness (including allergies) or other issues that may make sitting, standing, walking or doing simple mindfulness practices difficult for you? If yes, please tell us about it.*

Yes
No

Please explain*

Are you currently taking any medication which could have an impact on your participation on the course? If yes, please provide more details below.*

Yes
No

Please explain*

Do you have any difficulty with sight or hearing that we should know about? If yes, please tell us about it.*

Yes
No

Please explain*

To my knowledge, there are no personal mental health issues, trauma or major life events that are likely to affect my experience of this course.*

I agree - there are NO personal mental health issues, trauma or major life events that are likely to affect my experience of this course.
I disagree - there ARE personal mental health issues, trauma or major life events that are likely to affect my experience of this course.
I am not sure.

Please explain*

Have you had any previous experience of mindfulness?*

Yes
No

Please tell us about your experience of mindfulness*

If there anything else you think it would be helpful for us to be aware of, please feel free to use the box below to outline this.

Where did you hear about this course?*

Please enter the search term used*

Please state*

We’d love to stay in touch.*

I’d like to be kept up to date once I have completed Teach .breathe so I can find out about what’s on offer in the HUB, MiSP news and events, practice groups and training with MiSP in the future.
I’d prefer not to be contacted

Consent

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