Join At the CorePlease fill out this application, I look forward to being in touch soon! Name * First Name Last Name Pronouns Email * Phone (###) ### #### City/State/Country of practice Time Zone * Preferred Paymant Plan Monthly Upfront with discount Professional Background Degree and Licensure Date you recieved your license MM DD YYYY Current Workplace(s) and role(s) Have you had any previous training in AEDP? (if yes, please describe) Have you had any training in trauma treatment or other related modalities? (If yes, please briefly describe) Have you taken a training or course with me before? (If yes, which one?) What are you hoping to gain from this group? Anything else you'd like me to know about how you identify or about yourself? How did you hear about this training? Thank you!