General (not Swedish or Israeli) Application for International Immersion June, 2021

While the hours might tempt some to work at the same time as the course, we HIGHLY recommend that you do not combine workdays with Immersion - certainly no more than one or two emergency clients. Immersion is an intensive course; participating for 7.5 hours online is both physically and emotionally challenging!

Your Full Name*

First Last

Your Email*

Enter Email Confirm Email

Address of the institution / private practice where you work.*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

COUNTRY*

Phone #*

Please Provide a Phone Number where we can reach you, ideally by text. We will not share this number or call you for marketing or other purposes.

Please tell us about your license / credentials*

This course is intended for mental health care professionals in the field of psychotherapy or similar professions. Tell us what type of license you have - choose from below, or complete the "other" option

other from above: tell us about your "Other Licensed Mental Health Professional" license or credential

Professional Suffix (PhD, LCSW, etc)*

License Number (required for US Practitioners and everywhere where Licensing is required by law)

Languages*

A majority of this course's participants will be from Israel or Sweden; English will almost always be these participants' second language. So, for the balance of this Immersion's participants we are especially inviting clinicians, from all over the world who while fluent in English experience it as their second language. English-as-a-first-language participants may also apply - we are likely to include a few!

I am fluent in English, but my first language is Hebrew
I am fluent in English, but my first language is Swedish
My first language is English
Other: I am fluent in English, but my first language is ... see below

other from above: my first languge is ...

Why is this particular Immersion course of interest to you?*

The price of Immersion is $1599 USD due upon accceptance to hold your place.

Applicants will be accepted on a rolling basis. All applicants who have applied by the April 30 deadline will be notified of acceptance no later than May 6th, 2021, at which time they will be emailed a link to complete their registration and pay by either credit card or PayPal. Eligible applicants who are not accepted will be added to a waiting list.

If you have any questions please contact admin@aedpinstitute.org.

Thank you for applying!