Student Application (FB) – Restoring Resilience

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Form Instructions

This application is for first-time applicant admission in the SE™ Professional Training Program and not for enrollment into a specific cohort. Completing this application will take about 20 minutes. Please note that you will be required to upload your resume during this application process.

In addition to this application and your resume, applicants are also required to sign the Student Informed Consent Agreement and agree to the Student Policy Handbook and Agreements and Expectations.

You do not need to submit a new application to change cohorts. Please be sure to read through the transfer policy in the Student Policy Handbook for more information on the transfer process and fees.

Once we have received your complete application materials, processing will begin. Applicants will be notified by email of their application status within 15-30 business days.

Applications may take longer to be processed if:

it is incomplete (missing Student Informed Consent Agreement or CV) or needs follow-up information.

Legal Information

This is a legal document and you are expected to adhere to its terms.

Once complete, a copy of this document will be emailed to you for your records.

I hereby agree to the following: I am participating in the Somatic Experiencing® Training (“Training”) and any event organized by Somatic Experiencing International (“SEI”) of my own will and volition and voluntarily agree to all the terms and conditions of this Informed Consent and Release Agreement (“Agreement”). *I Agree

I understand that my participation in or involvement with the Training may present a health risk to me. I elect to proceed with the Training at my own risk and I accept full liability for my participation and involvement with the Training. If I withdraw from the Training due to any health risk, Restoring Resilience refund policy applies. *I Agree

I agree that all personal information of any participant relayed within the Training is strictly and completely confidential. I understand that while the names of students and assistants in my cohort will be shared with other participants in my training, I shall not disclose any of this confidential information to any other person or entity under any circumstances. I shall not make any recordings of any portion of the Training nor shall I duplicate, reproduce, distribute, publish, or discuss any of the confidential information contained in or related to the Training. *I Agree

I understand that SEI may record this Training and/or demonstrations from the Training. SEI will hold the only authorized recordings of the Training and/or demonstrations. I further understand that photographs may be taken by SEI at the Training. I understand that I have the right to refuse to participate in the photography or recording of the Training and/or demonstrations at any time. I shall not make any audio, video, or other recordings of any portion of the Training and/or demonstrations. *I Agree

I agree that SEI shall not be liable or responsible for any unauthorized recording of the Training and/or demonstrations. I also agree that SEI shall have no liability or responsibility for the use or exploitation of any unauthorized recordings. I understand that if at any time SEI approves the recording of a Training and/or demonstrations, a separate release agreement will be provided. I hold the right to decline signing the release form. I further understand that if I do not complete the release form, SEI will not share the Training and/or demonstrations recording outside of my Training cohort. *I Agree

If I agree to participate in the Training as the subject of a demonstration, I am doing so voluntarily and at my own risk. I understand that other students in my cohort may have access to a recording of the demonstration and that SEI is not liable for any unauthorized distribution of the recording by me or any third parties. I understand that the demonstration session may include questions about my personal trauma history and emotional, psychological, and physical symptoms I may be experiencing. I further understand that I am under no obligation to participate in the demonstration, that I may refuse to answer any question, and that I may pause or discontinue my participation in the demonstration at any time at my discretion. SEI has no liability or responsibility for my participation or involvement in any demonstrations and I accept that any result or no result may occur due to my participation or involvement. *I Agree

I understand that the primary purpose for receiving credited Personal Sessions is educational—to observe and experientially learn how SE™ principles are applied in practice so as to support my professional training and development. *I Agree

I understand and agree that all my sessions, meetings, and consultations with Personal Session and Case Consultation Providers (“Providers”) are undertaken at my own risk and that SEI does not monitor, control, influence, or regulate Providers. I hereby release SEI and its related parties from any and all liability or responsibility for any acts or omissions of any Provider and any claims related thereto. I understand that SEI makes no representations or warranties about the characteristics or quality of the services I may receive. *I Agree

I agree to abide by all SEI policies, procedures, and guidelines as posted on SEI website at traumahealing.org. All SEI policies, procedures, and guidelines are subject to change without notice to me and will be updated on SEI website. I understand and agree that it is my responsibility to check the website for updates and that I am nonetheless expected to adhere to all such policies, procedures, and guidelines. *I Agree

In the event that a grievance, complaint, or action has been brought or filed against me before any licensing, regulating, associative, or legal body for any violation or misconduct related to my profession and/or the use of SE, I will report it to SEI within fourteen (14) days of notification by emailing Legal@traumahealing.org. The legal department will keep this record in their confidential files for a minimum of seven (7) years to meet CE board requirements. Based on the determination or outcome of the filed grievance, complaint, or action, I understand that I may or may not be able to attend SE Trainings. *I Agree

I acknowledge that my CV and any grievances/complaints filed against me may be submitted to Continuing Education (“CE”) Boards as requested and will otherwise remain confidential with SEI as the privacy policy permits. *I Agree

I understand that SEI is the exclusive owner or licensee of all materials utilized in the Training including, but not limited to, all printed, audio, video, digital, online, and other materials (“Materials”). The Materials also include all duplicates, reproductions, and derivatives of the Materials, as well as any materials, research, books, articles, and other works of authorship, as well as products or services, created by SEI and related to the Training (collectively, “Materials”). SEI retains all rights in and to all intellectual property utilized or referenced in the Training and the Materials including, but not limited to, the copyrights in the Materials and all associated trademarks. No Materials or any portion thereof are sold or otherwise transferred, and SEI does not sell any title, ownership right, or interest in or to any of the Materials. *I Agree

If I wish to present Somatic Experiencing (SE™) in a public format or create a workshop/training that mentions/relates/explains SE™, I hereby agree and acknowledge that I must be approved by SEI to do so. (Please email IPAdmin@traumahealing.org for more information.) I further agree to represent myself as a student of SEI until my SE™ certificate has been obtained, at which point I may call myself a SEP. *I Agree

I agree, whilst in physical or online attendance at the Training or at any other event presented by the Organizer, that I will not advertise or promote trainings, seminars, workshops, newsletters or any other goods and services for myself or on behalf of any other individual or entity, be it by verbal means or by the use of any other form of promotional material, including but not limited to flyers, leaflets, and online materials or links. *I Agree

I understand and agree to provide SEI with emergency contact information for two (2) individuals. I understand that this information is being collected in order to assure my safety and well-being during the course of the SE™ Training and that my listed emergency contacts will only be contacted if necessary in situations where Faculty, Assistants, SEI staff and/or students in my Training have reason to be concerned for my safety. I understand this information is necessary due to the nature of the SE Training which may present a health risk to me during a time where I may be alone, specifically in the online training format. I understand that the emergency contact information below will not be shared with any person outside of my cohort and SEI staff and will be kept confidential to the extent permissible by law. *I Agree

EMERGENCY CONTACT INFORMATION

Primary Contact Name *

Relationship *

Phone *

Alt Phone *

Secondary Contact Name *

Relationship *

Phone *

Alt Phone *

AGREEMENT & SIGNATURE

By submitting this agreement, I certify that all the information included in this agreement is true and complete. I agree to appear and act in a professional manner at all times while participating at Trainings with SEI, and/or interacting with SE Training students, faculty, staff, assistants, and coordinators, both within and outside of the Training environment. I acknowledge that SEI reserves the right to approve or deny any application, revoke approval at any time, and approve or deny the participation of any person, in its sole discretion, with or without cause, and in accordance with its policies and the law. This Agreement is the only agreement between me and SEI regarding my participation in the Training, supersedes any other similar agreement, and cannot be modified except in writing by SEI. This Agreement will be binding upon me and my heirs, executors, administrators, and legal representatives. This Agreement is governed by the laws of the State of Colorado and any dispute arising from this Agreement or my relationship with SEI shall be submitted to binding arbitration in Boulder, Colorado in accordance with the Commercial Arbitration Procedures of the American Arbitration Association. Any resulting decision may be entered in a court of competent jurisdiction. *I Agree

Student Informed Consent and Release Agreement

I have signed the Student Informed Consent Agreement. Note: If you have not submitted a Student Informed Consent, your application will be "Incomplete" and the Admissions Team will reach out to you. *YesNo**PLEASE ONLY SELECT ONE OPTION**

Student Application Form

Have you ever had any grievances, complaints, or actions filed against you, pending or upheld, for misconduct of any kind as a professional before any licensing, regulating, associative, or legal body? *YesNo

Have you already provided the required information regarding any grievances, complaints, or actions to SEI's Legal Department? *YesNo

Not Eligible for Approval

PENDING STATUS

Based on your response you are not eligible for approval at this time and your request will be immediately placed in a pending status upon receipt. Please email legal@restoringresilience.com.au to provide additional information on this matter and for directions on how to proceed.

I understand that the SE™ Professional Training is an educational training and is not a space for personal trauma resolution work. It is not suitable for those solely seeking a personal-growth experience. I further acknowledge that content in the training curriculum may be activating. *YesNo