Registration for the October 22 – 23 Workshop

Online – Live
October 22-23, 2021
Hakomi Mindful Somatic Psychotherapy: An Experiential Introduction



Faculty: Hiromi Willingham, LCSW, Certified Hakomi Trainer
Hours: Friday and Saturday 9:30 am-12:45 pm and 1:45 pm-5:00 pm
Please note all hours are Eastern Standard Time (EST)
Cost: $295 if paid by Sep 20; $335 thereafter (includes $75 non-refundable deposit/admin fee)
CEs: 12 CE hours: NBCC (ACEP #5476) and NASW (note: NASW does not cover these states: NY, MI, WV, NJ, ID, OR)
This workshop can serve as the prerequisite for the Hakomi Comprehensive Training and is also designed to provide experiential learning in Hakomi for professionals and graduate students.
For more information:  Email southeast@hakomi.org or call us at 303-499-6699 ext. 5

Registration

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*Are you a student?
NoYes

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*Are you taking the workshop as (check one or more):
A prerequisite for the Hakomi Therapy TrainingA therapist or practitioner interested in learning more about HakomiFor personal growthFor other reasons (describe below)

If taking the workshop for other reasons, please describe:

*How did you hear about the Hakomi Therapy? (Check one or more)
Hakomi Institute WebsiteHakomi EmailPsychotherapy Networker: (Website, print magazine or conference?)Friend/ReferralOther (describe):

*CE’s requested:
NBCCSocial workerMFT (NBCC)Professional counselor (NBCC)No CEs requested

*Are there accommodations you require to make the workshop accessible?
NoYes
If you require accommodations, please describe

*How do you identify yourself to others? i.e. is there anything you want our teaching team to
know about your *social location, cultural identity, or other group membership (and optionally)
that could help you participate more fully in the training? *An individual's social location is
defined as the combination of factors including gender, race, social class, age, ability, religion,
sexual orientation, and geographic location. This makes social location particular to each
individual; that is, social location is not always exactly the same for any two individuals:

What other information would you like to share about yourself?

*By typing my name here, I agree to pay for the entire workshop whether or not I attend both
days. Refunds only on cancellations made at least 72 hours prior to workshop (less $75
registration fee)