Annual Dues – Therapist / Practitioner

Hakomi Institute Annual Dues 2019

Dues form for
Certified Hakomi Therapists / Certified Hakomi Practitioners

Due Date: June 1, 2019

*(Required)

*Your Name


Directory of Practitioners website listing
Please only fill this section if there are CHANGES to your current listing

NO CHANGES

Change Degree/Credentials to: (Please use only abbreviations):

Change address to:

Change phone number to:

Change email to:

Change website to:

If you are adding your website for the first time, we ask you to reciprocate with a link to our website, as this helps with our search engine rankings, which benefits us all. Once you have added this link to your website, please let us know the page where this link is located, and we will add your web address to your listing on the Hakomi Institute website.


Changes to extended listing in Directory of Practitioners

An Extended Listing is 45 words describing your practice for an extra $30 (U.S.) or $25 (International):

Please enter the entire revised text here:

You may edit the “Basic” part of your Directory of Practitioners listing (name, credentials address, email, phone, website) at any time during the year when we do our monthly updates, but the “Extended” part of your listing may only be edited annually when you pay your dues.


If your postal address is different from the address on your website, please enter it below.

Note: complete this section only if this address has changed over the past year.

Change address to:


Please, check your Hakomi Institute website listing for accuracy once it is posted.

This is usually the first week of the month after we receive your payment. The Hakomi Institute does not take responsibility for errors or typos which may occur when our staff and webmaster enter your listing.