Gestalt Training Application

Please complete the application below and attach your resume. The $85 application fee covers the cost of processing the application and a personal interview with one of our staff.

Name:(Required)

First Last

Pronouns Used:

Date of Birth:(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone Number:(Required)

Email:(Required)

How did you hear about the Pennsylvania Gestalt Center?(Required)

Which, if any, Pennsylvania Gestalt Center events have you attended previously?

Please tell us your interest in Gestalt therapy and reasons for wanting to join the Training Program (required).

If you prefer, you may upload a letter below.

What else would you like us to know about you?

Please attach your resume.

Please upload your resume in PDF or Word format.

Accepted file types: pdf, doc, docx, Max. file size: 32 MB.

Please tell us your interest in Gestalt therapy and reasons for wanting to join the Training Program

If you prefer to upload a letter of interest, please attach it here (optional).

Accepted file types: pdf, doc, docx, Max. file size: 32 MB.

Application Fee Payment(Required)

Price:

Payment Method

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Comments

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