Form test Personal informationName(Required) First Last Email(Required) Address(Required) AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country I am planning to attend this course with the goal of full certification(Required) Yes No (If you click no, you are still welcome to join all the content and call of the course, but we won’t track your course work and we won’t assign you to a peer group).What age are you?(Required) Under 25 26-35 36-45 46-55 56-65 65+ What is your profession?(Required) Coach Therapist Dance Teacher/Trainer Meditation / Mindfulness Teacher Yoga teacher/Trainer Martial Arts teacher/Trainer Body worker Improv/theatre/arts teacher Human resources Other Which experience of personal practice in meditation do you have?(Required) None Under 1 year 1-3 years 3-6 years 6-10 years Over 10 years Please describe your meditation approach and main techniques you practice?(Required)Which of the following are you currently experiencing regularly in your personal practice?(Required) Sleepiness / drowsiness Restlessness / difficulty to be still High levels of distraction Very active self-critic Boredom Hyper arousal (inability to be at ease, signs of anxiety, flight / flight response present in the body) Hypo arousal (inability to stay present, signs of freeze / collapse / disassociation response in the body) Overwhelmed by physical discomfort / pain Overwhelmed by emotional discomfort / pain Any other issues?Please describeDo you have any current mental health issues? If yes, and you are comfortable doing so, please give a brief description.(Required)(Note: if you’re currently experiencing severe mental health issues this may not be a good time to do the course, and we may recommend you consult with your physician or therapist).Do you have experience in teaching meditation?(Required) Yes No Do you have experience in applying mindfulness techniques in your work, with clients or students?(Required) Yes No If yes, please mention how you use itExpectationsAre you planning to get certified as an embodied meditation teacher?(Required) Yes No I will decide after the first 3 months of the course In two sentences or less, what is motivating you to commit to this course? What do you aim to get out of it? How will you know that you have succeeded?(Required)What is your biggest concern about completing the course?(Required)Sales feedbackHad you heard of Embodiment Unlimited prior to purchasing this course?(Required) Yes No How did you know about this course?(Required) Facebook EU group Instagram EU account EU Emails – I’m a subscriber From teachers on the course From friend/colleague From Embodied Meditation Week (EMW) If you attended Embodied Meditation Week did you: Mostly attend live Mostly watch replays Didn’t attend How many sessions: 1-3 4-6 7+ For the sessions you attended, please rate them from 1 (learnt nothing) to 5 (enlightening)What is embodied meditation and are you doing itPlease enter a number from 1 to 5.Two embodied meditation techniquesPlease enter a number from 1 to 5.Two more embodied meditation techniquesPlease enter a number from 1 to 5.Add bodily depth to your practicePlease enter a number from 1 to 5.Help students to come home to their bodyPlease enter a number from 1 to 5.Help students integrate meditation into daily lifePlease enter a number from 1 to 5.Help students not spiritually bypass/ Overcome spiritual bypassingPlease enter a number from 1 to 5.From Mindfulness to Meditation to Non-Duality to LiberationPlease enter a number from 1 to 5.Meditation Stages & Their DifficultiesPlease enter a number from 1 to 5.The Body’s Journey Through MeditationPlease enter a number from 1 to 5.Tissues of Earth: Ecosystems of your Interior BodyPlease enter a number from 1 to 5.Meditation for People Who Can't Sit StillPlease enter a number from 1 to 5.Opening to the Body’s Subtle AttunementPlease enter a number from 1 to 5.Non-Attachment MeditationPlease enter a number from 1 to 5.Making Friends with Yourself and Awakening Your Basic GoodnessPlease enter a number from 1 to 5.Pleasure & Joy in meditationPlease enter a number from 1 to 5.Settling your Mind/Body with BreathworkPlease enter a number from 1 to 5.Meditationsmythen (German-language session)Please enter a number from 1 to 5.Please pick 3 favourite teachers from EMWAdd all names here please
