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Worksheet

Somatic Experiencing® Professional Training Program Application - 2026/2027 Cohort

Thank you for your interest in the Somatic Experiencing Professional Training. We are pleased to welcome you to our online application process. This application will take approximately 30 minutes to complete. 

A few things to note BEFORE you begin the application:

1. You MUST complete the entire application in one sitting. We strongly recommend that if you do need a break, you keep the web page with the application open and return to it.  

2. Applications are processed on a first come, first registered basis. A student's spot is only secured once a payment has been received (either in full or through a payment plan).  

3. There are sections of this application for you to upload supporting documents. If you do not have a Gmail account, this option may not be available to you and as such, you may need to email those documents to us instead.  Sending (uploading) supporting documents to us as soon as possible will ensure your successful registration.

4. Once you have been registered for the training you will receive a confirmation email with additional Releases and Consents to be signed and returned PRIOR to the first day of training.  

5. Please be sure to add selondon@patriciaberendsen.com to your email address book to ensure successful communication with us. 


* Indicates a required question
1. ➜

Full Name (First and Last Name) *

2. ➜

Preferred Name (if applicable)

3. ➜

Pronouns *

4. ➜

If other, please specify:

5. ➜

Street address

6. ➜

City *

7. ➜

Province *

8. ➜

Country *

9. ➜

Postal Code *

10. ➜

Primary Phone Number *

11. ➜

E-mail Address *

Note: we send ALL information via email, so please provide an email address that you check on a regular basis - and be sure to check your spam folder as well. It is recommended that you avoid using an educational institution email, as these accounts often block incoming messages. Please use a Gmail, Hotmail, or similar personal email address instead.

12. ➜

Mailing List

Do you want to join our mailing list to receive information about additional workshops, training and programming being offered through our center?

13. ➜

Level of Education *

14. ➜

If other, please specify:

15. ➜

Professional Occupation *

16. ➜

Field of Specialty (if applicable)

17. ➜

Registration Number of Your Governing Body *

Note: Please state none or not applicable if you do not report to a governing body. 

18. ➜

Do you have any grievances, complaints, or actions pending or upheld against you for misconduct as a professional by any licensing, regulating or associative body?

19. ➜

If Yes, please provide full details and copies of all relevant information:

20. ➜

Please Upload Your Resume

Note: Not uploading will delay review process. Please use word or pdf formatting. 

21. ➜

Please upload most recent SE training certificate

This applies to individuals who are switching to the London, Ontario SE training cohort from another SE training cohort Note: Not uploading will delay review process. Please use word or pdf formatting. 

22. ➜

Please upload a recent headshot (JPEG Format)

Once an application is approved, the standard procedure involves updating the student portal with the participant's headshot and biographies. 

23. ➜

Biography*

Please make your responses concise but with enough information for us and the facilitator to know you. Enter your bio in the field below. 

Please include the following information in your biography:

  • Your current professional practice 
  • Number of clients you see each week 
  • A short statement indicating your primary interest in learning SE® 

Payment Information

The fee for the training per module is $1325 + HST ($172.25) = $1497.25  

Payment links would be issued with your approval/acceptance notice. 
24. ➜

What training are you applying for?

25. ➜

Are you a member of any of the following communities? (Select all that apply)

26. ➜

If other, please specify:

Please be sure to review each of the following sections thoroughly prior to agreeing. Please check the box after each section.

27. ➜

All information submitted will be held in strict confidence. The review process per application begins in March 2026. You will be notified by email of your application status thereafter. Applications are approved on a case-by-case basis. Patricia Berendsen and Associates Trauma Healing Center of London reserves the right to approve or deny any application without explanation and will provide a full refund. 

28. ➜

We reserve the right to cancel and/or reschedule any Beginning 1 class due to low enrollment prior to the start of the class. Should your class be canceled, you will be notified as soon as possible. A full tuition will be issued OR the funds may be transferred to another class.

29. ➜

Patricia Berendsen (nor SEI) are not liable for expenses incurred due to cancellation, included but not limited to  "travel and/or accommodation fees and/or any cancellation fees”.


30. ➜

It is possible that SE training topics could be triggering. We encourage you to ensure that you have support (which can be whatever that looks like or is best for you) at the training and afterwards. 


31. ➜

Refund Policy

Cancelling more than 30 days prior to the training: You will receive a full refund minus an administrative fee of $200.  

Cancelling less than 30 days prior to the training: You will receive a 50% refund of your registration fee.


32. ➜

Photography and Video Disclaimer

The Trauma Healing Centre of London reserves the right to photograph and record training sessions in whole or in part. By registering for this event, you understand and acknowledge that photographs and videos with your image may be used at the discretion of the Trauma Healing Centre of London.  These are intended to support educational professional development. Images and videos may also be used in publications and/or marketing graphics. 


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