GERI Immersion & Facilitator Training Application

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GERI Immersion & Facilitator Training Application

"*" indicates required fields

Are you applying for the online or in-person training?*

Online

In Person

Which training are you applying to?*

North America

South Africa

India

Latin America

Kenya / East Africa

Other

Name*

First Last

Email*

Enter Email Confirm Email

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of Birth*

MM slash DD slash YYYY

Marital Status*

Single

Married

Divorced

Widowed

Partnered but not married

Children: Number/Ages*

First or preferred language:*

Other spoken languages:

Education:*

Occupation:*

Emergency Contact*

Who can we contact in event of emergency? Please list name, relation, and phone number.

Organization (if applicable):

Have you ever participated in an in-person or online introductory Gender Equity and Reconciliation International program (either the three-day program, or 6-7 week course version)? If so, please tell us where and when.*

Are you an alumnus of a GERI Facilitator Training? If so, please tell us where and when you attended a training, and your certification date/year.

Please share with us your Spiritual/Religious Tradition or Expression, if you identify in this way.

Gender

Woman

Man

Non-Binary

Not Specified

If 'Non-binary' or 'Not Specified', please share your gender identity and/or expression.

As part of your application for the GERI training please include a recent headshot photograph of yourself. This can be a selfie! Upload a Photo:

Max. file size: 10 MB.

I would like to apply for financial assistance to attend this Training.

Please send me a scholarship/bursary application.

Limited financial assistance may be available.

How did you hear about Gender Equity and Reconciliation International?*

We ask each applicant to tick the circle below, to affirm your intention for participating in Gender Equity and Reconciliation International work: In joining this Gender Equity and Reconciliation International Training program, I bring a sincere intention to foster healing and reconciliation across the gender divisions in human society, and I commit to uphold my part in maintaining a safe space for every person in the Training and any GERI programs and events.*

I agree

Training Phases

Phase I is the foundational training program in Gender Equity and Reconciliation International.

Phase II, Internship Program, is for those who have successfully completed Phases I and wish to deepen their learning, or work toward becoming facilitators of Gender Equity and Reconciliation International. Trainees must be approved by the GERI Training Team for Phase II upon completion of Phase I.

Phase III, Facilitation Certification. After successful completion of Phases I & II a trainee may apply to become a certified Facilitator of Gender Equity and Reconciliation International Online Programs.

Which Training Phase are you interested in pursuing:*

Phase I

Phase I & II

Phase I & II & III

Section 2: To be completed by all applicants

As part of the application process, we would like to know more about you and your interest in this program. Please reflect on and respond as honestly as possible to the following questions. Your information will be kept confidential.

1. Why are you interested in the Gender Equity and Reconciliation International program? What draws you to participate in a deeper immersion into gender issues?*

2. What personal life experiences and professional skills do you have that might be valuable and support you during this training?*

3. List three or more personal goals or aspirations that you have for this training.*

4. Please share how you have experienced or witnessed gender conditioning in society. Feel free to share your experience from the lens of your particular culture, race, age, ability, faith, sexual orientation, gender identity, etc. This may be on a global level, or in your daily life, including in your community, personal relationships, family, work, school, religious/spiritual community, etc.*

5. Do you have a spiritual practice (meditation, prayer, mindfulness, etc)? If so, please tell us about your practice.*

6. Gender Equity and Reconciliation International trainings are experiential and include a variety of different activities and modalities (guided meditation, group process dynamics, psychodrama, movement, etc.), which by their nature have the potential of awakening new levels of consciousness within an individual. It is important for us as the facilitators of this training to know of any health concerns or issues that you may have currently or in the past. Providing this information will not in and of itself exclude an applicant from entering the training. Please be honest in your response knowing your answers are confidential as well as appreciated and valued. Please tell us if you have or have had heart disease, hypertension, depression, gender or sexual trauma, episodes of mental or emotional illness, or any recent surgeries or hospitalizations. Also, have you worked with a professional therapist in the past or are you presently in therapy?

7. Do you use recreational (mind altering) drugs and/or drink alcohol? If so, what drugs and/or alcohol do you use, how often, and how much? Do you smoke? How often and how much? Do you want to quit? Do you use pornography? If so, how often and do you have an intention to quit.*

8. Please describe who you are as a person. Please include what you consider to be a few of your strengths as well as some challenges that you struggle with. What positive and critical feedback and reflection have others given you?*

In support of your application, we also ask that you provide recommendations from two professionals who know you; these could be teachers, community leaders, therapists, spiritual or religious mentors, etc. Please have your references include their reflections on your personal character, as well as comments regarding your professional skills and attributes that would support your participation in the Gender Equity and Reconciliation International Training.

Please have your references email the recommendation letter to: training@GRworld.org.

9. Please list the names, relationships, and emails of your two references in the space below.*

10. (Optional) Please add anything further that you think or feel will be helpful to us in considering your application for this Training.

Section 3: Phase II and Phase III applicants only

If you are applying for Phase I only, you have completed the application form. Please scroll to the end of this form and push Submit.

1. If you are interested in becoming a Gender Equity and Reconciliation International facilitator, please share why you want to become a facilitator of this work. *

2, Do you have any facilitation experience? If so, please list the kinds of programs and processes you have facilitated and/or been certified to facilitate. Please list dates and places of any facilitation certifications you have.*

3. If you do have facilitation experience, where do you think you need further development as a facilitator?*

GERI Immersion & Facilitator Training Application