First Name
Last Name
Full name exactly as you want it to appear on your Instructor's Certificate. (Example: Prof. Susan S. Sounder , Ph.D., GCFP)
Street Address
City
State or Province (U.S. or Canada only. Others leave blank.)
Zip Code or Postal Code. (All countries.)
Country
Email Address (If none, leave blank.)
City, Country, and Dates of your SECOND training segment.
City, Country, and Dates of your FIRST training segment. (Example: Los Angeles, USA, November 9-11, 2003.)
City, Country, and Dates of your THIRD training segment.
What is the total number of SOUNDER SLEEP training days you have attended?
8 days
9 days
10 days
More than 10 days
Ten (10) hours of SOUNDER SLEEP teaching experience are required prior to Teaching Authorization. Have you completed this requirement?
Yes, I have completed the teaching requirement!
No, I haven't completed it yet.
In your own words, how would you describe the SOUNDER SLEEP SYSTEM to a potential student, or a group of interested lay people? (300 words or less)
Please describe your own personal practice of the SOUNDER SLEEP SYSTEM . Which Mini-Moves are most valuable to you? When and how often do you practice? What are the benefits for you? (300 words or less)
Why does our insomnia solution include daytime relaxation techniques? Why don't we do sleep-inducing Mini-Moves at bedtime only? (300 words or less)
Are you a Member of our web site at soundersleep.com? (Current membership is required before this application can be approved. Click here to enroll.)
Yes, I am a current Member!
No, I will enroll within 24 hours.
Please help me to enroll.
A $25 application is due upon submission of this Certificate. Have you submitted your fee? (Here's a link you can use to pay on-line now. )
Yes, I have paid on-line!
Not yet. I will pay on-line within 24 hours.
Hold my application until you receive payment.
Optional: Please upload a photo of yourself (no more than 200 pixels wide or 50 KB file size, please). We'd love to see your smiling face, and it will help us to identify you when we're processing your application!
Enter your comments or additional information about your application.
