old Body Up! Level One Certification Application Form Please enable JavaScript in your browser to complete this form.Name *Date *Address *Email *Phone Number *Why are you interested in learning Body Up! Co-Regulation? * Embodiment Skills: A. What activities, training or practices in your life have developed your capacity for sensing your own body? (e.g. yoga, sports, dance, physical labor). *Embodiment skills, Communication skills and Self regulation skills Basic skills competency is a necessary foundation for learning to be a Body Up! Co-Regulation Practitioner. This form helps both of us to assess your basic competency. All three areas are relevant and will be considered. If you have extensive experience, just include a few highlights!Embodiment Skills: B. What activities, training or practices have developed your capacity for sensing your own body, in relational space (meaning around others)? (e.g. child care, parenting, training animals, partner dance, contact improv, collaborative physical labor). *Embodiment Skills: C. What activities, training or practices have developed your capacity for somatic resonance (reading other people’s bodily comfort or discomfort)? (e.g. parenting, doing bodywork, being a lover, teaching body based activities, being an empath) *Verbal Communication Skills: A. What activities, training, experience or practices have developed your capacity to talk about your own and other people’s physical experience? (e.g. being a healer, working with children, teaching body based activities, sports, tasks, yoga) *Verbal Communication Skills:B. What activities, training or practices have developed your capacity to adjust your language to your communication partner’s level? (E.g. working with: children, people who speak a different language or see the world very differently from you, people with high levels of dysregulation) *Self Regulation Skills: A. What activities, training, experience or practices have developed your capacity to track, understand and regulate your nervous system? (e.g. parenting, management positions, teaching, living in community, following through on difficult, long term projects, mediation or therapy, being a trailblazer or innovator, and last but not least, surviving trauma) *Self Regulation Skills: B. What are your self regulation challenges? (e.g. anger, hyper-vigilance, despair, anxiety, getting overwhelmed by intensity or complexity, deadlines, issues around money, sex or power, rejection, shame, loss,) *Current Occupation - years in this work *This section helps us understand the skills and perspective you come in with. If you prefer to attach a resume, just be sure it covers the questions below.Previous Work History or Relevant Experience: *This section also helps us understand the skills and perspective you come in with. If you prefer to attach a resume, just be sure it covers the questions below. Education/Degrees: *Professional Associations or Community Memberships: Personal Development (courses, programs, etc and # of hours): Personal Practices: *E.g. Yoga, meditation, dance, exercise, service etc.Please share any other information (concerns?) you feel would be relevant to this application.PhoneSubmit
