LEVEL 1 APPLICATION

Please provide all required information on this form before clicking on SUMBIT.

You should receive an email confirming the receipt of your application within two weeks of submitting your form. If you do not receive a confirmation within this time please email Tamalpa.

If you have not already done so, please pay your $75 application fee after submitting your application form. Instructions for paying your application fee are available under ADMISSIONS.

Note: Required information on this form is marked with an asterisk (*). You will only be able to submit the form when all required information has been entered/uploaded. If you do not have an answer for one of the required boxes write “N/A”.

Name:*
First Last
Email:*
Enter Email Confirm Email
Training Format:*
Do you intend to go to Level 2?*
Recordings of Zoom Training Seminars*
Training seminars that take place on Zoom are recorded and the video recordings are made available to students for purposes of make-up and review upon request. Video recordings of training seminars are only available to students who are enrolled in that specific training. To maintain confidentiality, video recordings are not to be shared outside of the student cohort. All course material presented in these videos is under the copyright of Tamalpa Institute. All students are required to sign a Zoom recording waiver and a form confirming they have read the Student Handbook which describes students’ responsibility for confidentiality within their cohort and guidelines regarding copyright of intellectual property.
- I have read and understand the above statement regarding the recording of Zoom training seminars.
The following are required for participating in online training sessions. Please confirm that you have access to the following by checking the box next to each requirement.
- Access to a private, well-lit space
- Space to move around in
- A reliable internet connection
Have you participated in a Tamalpa Institute Workshop?*
- Yes, I have taken a Tamalpa Institute Workshop
- No, I have never taken a Tamalpa Institute Workshop
If yes, what Workshop did you participate in?
How did you hear about Tamalpa Institute?*
Permanent Address:*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Area Code + Phone:*
Gender Pronouns:
Level of Education:*
Occupation:*
Date of Birth:*
Country of Birth:*
Country of Citizenship:*
Emergency Contact Name:*
Emergency Contact Phone:*
Emergency Contact Email:*
Application Fee Payment Method:
Please upload a full length photo of yourself:
Please upload your high school diploma or equivalent
Autobiographical essay/ArtCorps Personal Statement*
A autobiographical essay, typewritten and no more than 4 pages that addresses the following: A brief autobiography describing your background, interests and any relevant highlights of your life. Describe your current personal and professional goals. How do you want to apply the training in the Tamalpa Life/Art Process to your personal and professional life? What specific life issues or themes are you currently working with that you would like to explore within the context of the training? What do you imagine your strengths and challenges to be in a group learning environment? How did you hear about Tamalpa Institute? IF you are applying for an ArtCorps Scholarship, please include your ArtCorps Personal Statement within your autobiographical essay.
Drop files here or
Letters of Recommendation (can also be emailed separately to the Tamalpa Office)
Two letters of recommendation. Please email signed copies of the letters here or have your references email their letters directly to us. Handwritten letters will not be accepted. Letters of recommendation must be from teachers, therapists, employers, or other professional relationships only. Letters from friends, clients, students or family members will not be accepted. **For ArtCorps Applicants Only: One additional letter of recommendation specifically for the ArtCorps Scholarship application. The letter of recommendation must be written by: a. Current or former supervisors/mentors/colleagues who can specifically address the applicant’s role in projects or activities discussed in the applicant’s personal statement. b. Groups or organizations that have benefited from the programs and/or activities discussed in the applicant’s personal statement.
Physical and Mental Health Survey
Tamalpa Institute is a school for movement-based expressive arts therapy. It is necessary that we assess the physical, mental, emotional issues that might affect a student in the training program. In order to ensure that we are able to maintain a healthy supportive learning environment for all our students, we have included some specific questions regarding mental and physical health, below. Please note that confidentiality will be maintained to the fullest extent. The institute does not discriminate against anyone on the basis of any actual or perceived disability. The purpose of this questionnaire is to assist you and us in deciding whether our program is right for you, and whether you may require any extra assistance to fully participate in and benefit from our program. While the program can be very therapeutic, it may be beyond the scope of the training program to provide specifically for the mental health needs of an individual student. If a student is likely to need 1:1 therapeutic support, we aim to recognize this in advance and discuss with the student how to structure this support. It is our policy that faculty members do not act as therapists for individual students, since this is a dual role. We have a local resource list that includes mental health professionals. Meetings will be scheduled for each student with Program Coordinator: Amy McGrath. At these meetings, there is an opportunity to discuss any need for individual therapeutic support (outside of the training program) during the course of the training, as well as how we can best support you within the context of the classroom if needed, within the parameters of the curriculum and the group context. Please answer these questions, as the starting point of a conversation:
Please list all physical health conditions for which you are currently undergoing treatment. Please list the names and contact info of your healthcare providers (if relevant)*
Do you have any allergies?*
Please list medication that you are currently taking. Please make sure that you have enough medication to last during the program that you are enrolled for.*
Please list any physical conditions that you have received treatment for in the past that could potentially recur. Please include injuries as well as any conditions that are chronic and could possibly recur in the future. Please especially note any condition that could be exacerbated by an intensive movement-therapy training program.*
Have you been hospitalized for mental health reasons? If so, please give dates and duration of hospitalization, and the diagnosis.*
Are you currently taking medication for mental health reasons? Please list:*
Have you been prescribed psychoactive medication? Please list:*
Have you experienced any of the following? *severe depression or anxiety *manic episodes *suicidal thoughts *paranoia*
Have you been diagnosed with an eating disorder?*
If you should need therapeutic support, what resources do you currently have available?*
Is there anything else you want to let us know about your mental /emotional health that would help us to ensure your successful journey through our training program.*
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LEVEL 1 APPLICATION

LEVEL 1 APPLICATION

Physical and Mental Health Survey

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