Application for Magnificent 9+1, March – June 2021

We are excited that you are applying to participate in Diana Fosha's Magnificent '9+1' Online course! You will be notified within 10 business days of submitting your application of one of the following results: - you have been accepted - at which time you wil be asked to register and pay (this would be the time to apply for a Diversity or COVID scholarship) - you have been added to the course waiting list: meaning you are eligible but this instance of the 'Magnificent' course is full. - you are ineligible at this time due to Level requirements. Thank you!

Name
First Last
Email
Where do you live?
City State / Province / Region Country
License Type - Required for North Americans and wherever licensing is required for mental health therapists.

example: LCSW, MFT, PsyD, etc.
License Number - Required for North Americans and wherever licensing is required for mental health therapists.
YOUR AEDP LEVEL: This course is designed for advanced AEDPers - Level 3 or above or advanced Level 2.*
Level 3 AEDPers have completed Immersion plus at least 1 major course of supervision (core training, 20+ hrs individual supervision or 30+ hrs group supervision) AND (i.e. PLUS) any 2 of the following: ES1, ES2, Core Training, 20 hours individual supervision, 30 hrs group supervision. Please indicate your Level above. For more information on training levels go to: https://aedpinstitute.org/certification/training-levels/
Have you been an Experiential Assistant in Essential Skills*
Notes regarding why I hope to be given an exception to the Level prerequisite