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Immersion course application (Africa)
AEDP Immersion Application: version for African participants including relevant pricing and contact info
Please tell us about your training / credentials / professional license
*
This course is intended for mental health care professionals in the field of psychotherapy or similar professions. Tell us what type of training / credentials / license and professional experience - choose from below, or complete the "other" option
Choose an authorized profession
Psychologist
Psychotherapist
Psychiatrist
Marriage and Family Therapist
Social Worker
Counselour
*Other Mental Health Professional
*Other from above: tell us about your "Other Mental Health Professional" license or credential
More about your licensing and/or clinical experience
*
If you are a licensed mental health practitioner, you may skip this question and tell us your license number country below. If you are/were licensed in another country but practice in Africa, please tell us the country where you were trained and were/are licensed, the date you were licensed there and under what "licensing board;" and please tell us how long and in what setting (private practice or institution) you practice today. Other applicants, please tell us about your clinical experience: how many years have you been working with patients? Are you now or have you been -formally or informally- in supervision with a counselour or otherwise in training with other mental health care professionals? Tell us about your practice setting (private practice or instituion)? and anything else you would like us to know - thank you!
Your Full Name
*
First
Last
Professional Suffix (PhD, LCSW, etc)
*
License Number if applicable
Address of the institution / private practice where you work.
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
COUNTRY
*
Please tell us the country where you work.
COUNTRY CODE for telephone and What'sApp outside of North America
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.
Your Email
*
Enter Email
Confirm Email
The general price of the course for Africans is $240 USD.
All self-identifying Black mental health professionals are welcome to pay $0 as part of our 'pay-what-you-wish' pilot program - learn more here: https://aedpinstitute.org/in-solidarity-black-lives-matter-june-2020-letter-to-the-aedp-community/.
Accepted applicants who have applied by November 20th will be notified of their acceptance by November 30th, 2020, at which time they will be emailed a link to complete their registration and, if payment is required, pay by either credit card or PayPal.
For questions, please contact karindorell@mac.com
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