Application Form | The Shift Training & Coaching

PERSONAL DETAILS SECTION

Name

Address / Post Code / Country

Phone Number

Date of Birth

Gender

Occupation/Most recent occupation

PERSONAL HISTORY SECTION - To assist me to offer you the most professional level of support, please provide me with the following details

How would you describe your illness/symptoms/issues? (include medical name/diagnosis if relevant)

When did your symptoms/issues begin?

Date of diagnosis (if relevant)

Name(s) of consultant or doctor

How did the symptoms/issues start?

How has this affected your life?

APPLICATION QUESTIONS

Have you listened to the 'Part 1 of the Lightning Process' audio programme or read the Introduction book?

Are you willing to attend and participate in the discussions, training and coaching sessions?

Do you feel you can influence your own health?

Do you believe you can get better/resolve your issues?

What do you hope to achieve from doing the course?

When you resolve your issues, what would you love to do with your life?

Have you applied to take the Lightning Process training before?

If yes, which practitioner did you apply to and when?

What has changed for you since applying with that practitioner?

Should I need to speak to that practitioner about your application, please confirm that this is okay with you.

Do you know of someone who has resolved their issues by doing the Lightning Process?

How did you hear about the Lightning Process?

How did you hear about Libby Gairdner and The Shift?

AGREEMENT - NB If you are under 18 your parent or guardian will need to read and accept the Terms and Conditions on your behalf.

I have read and accepted the Terms and Conditions

Parent/Guardian (if applicable)

THE FOLLOWING QUESTIONS RELATE TO THE DATA PROTECTION POLICY SECTION OF THE TERMS AND CONDITIONS

I would like to have my attendance certificate logged with the Lightning Process Head Office

I wish to receive occasional and relevant correspondence about developments in the Lightning Process

I give my permission to be contacted at regular intervals to monitor my progress for the purpose of further research into the Lightning Process

Address

Your application has been submitted. Libby will contact you soon.

Application for Lightning Process