Guest Workshop Application - Mindfulness in Schools Project

Please select the Guest Workshop you are applying for*

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

Full Name*

Email address*

Please check that this is entered correctly.

House number or name*

Street*

Town or city*

County or state*

Postcode*

Country*

Region*

Home telephone number (please include country code)*

Mobile telephone number (please include country code)*

Emergency Contact name and number whilst on the Workshop:

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

Emergency Contact Name*

Emergency Contact Landline No:*

Emergency Contact Mobile No:*

Your Employment:

Your Profession*

Your Employer*

Postcode of your employer*

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:*

What is your experience of mindfulness?*

None
Informal practice
Daily personal practice
Other

Please provide details of your mindfulness experience:*

Have you completed an instructor-led 8 week mindfulness course?*

Yes
No

Which 8-week course did you complete?*

Are you trained to teach mindfulness?*

Yes
No

Please tick those courses that you teach:*

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.b Foundations
Other

Please provide name of course:*

Where did you hear about this Workshop?*

Please state*

Please enter the search term used*

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.

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*

There will periods during the Workshop 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, this Workshop please do let us know. Please be assured that any personal information you disclose will be treated in the strictest confidence.*

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

Special Requirements e.g. any accessibility requirements/ other information relevant to this workshop

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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.

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