ࡱ> wyvb jbjb .HhhN8N4N,,,,k> GIIIIII,RXugkuU,,;UUU(,,GU$6GUUG BdG0,* U* GUNN2 NN2 Date: SACRED CENTERS CO-HEART CERTIFICATION PROGRAM APPLICATION Co-Heart Certification offers a guided pathway of thorough chakra study and personal growth. Students gain skills and principles for manifesting their visions as well as tools for balancing their chakras. Co-heart graduates report accelerated life fulfillment. Co-Heart Certification has no prerequisites and is open to anyone. A certificate is granted for completing the four basic courses, listed below, a short reading list and an interview with Sacred Centers faculty member to share your learning or a one or two page written learning report that demonstrates a solid understanding of the material. Requirements for completing the Co-Heart level include Courses 101 through 104:  HYPERLINK "http://sacredcenters.com/workshops/workshops-a-z/seven-windows/" 101 Seven Wonders of the Soul (Basic Chakra Weekend)  HYPERLINK "http://sacredcenters.com/workshops/workshops-a-z/energy-awareness/" 102 Energy Awareness or suitable equivalent (weekend)  HYPERLINK "http://sacredcenters.com/workshops/workshops-a-z/psychology-of-the-chakras/" 103 Chakra Awakening: Psychology of the Chakras (Week-long Intensive)  HYPERLINK "http://sacredcenters.com/workshops/workshops-a-z/creation-is-ecstasy/" 104 Creation is Ecstasy! Manifestation Workshop Manifestation through the Chakras (3 day) Reading of  HYPERLINK "http://shop.sacredcenters.com/products/wheels-of-life" Wheels of Life and listening to  HYPERLINK "http://shop.sacredcenters.com/products/the-chakra-system-deluxe-6-cd-set" The Chakra System audio CD set Please answer all questions as accurately as possible. Information will be kept confidential among the Sacred Centers staff. Those questions marked with an asterisk (*) are better answered in a personal essay. GENERAL INFORMATION: Name: Address: City, State, Zip: Email: Phone (home and work): Phone (cell): Best times to reach you: Date of Birth: PAST EXPERIENCE: Occupation: Employment: Dates: What programs in this curriculum have you already taken? When and where? Please tell us in detail why you want to undertake this program and what you intend to do with it when you have finished.* SPIRITUAL PRACTICE: Please list your personal spiritual practices, indicating nature of practice, frequency and duration (i.e. practice hatha yoga 4x week for one hour for 2-3 years, or practice meditation 2x day for 15 years, or sing, chant, dance, volunteer services, walk in woods, etc.)* EMERGENCY CONTACTS : (These will be used in emergency only) Friend or family member: phone: Medical doctor: phone: Therapist: phone: Certification Program Agreement Please read carefully and sign below. OBJECTIVES OF SACRED CENTERS COHEART CERTIFICATION: 1. To further the consciousness, spiritual growth, and healing of all who partake by utilizing the tools and wisdom of the chakra system. 2. To enable students to apply the tools and understanding of the chakra system in their current lives, for personal growth as well as apply when appropriate in work or other venues. 3. To provide peer support and community based on the sharing of this knowledge. 5. To better the world around us by supporting the expansion of individual and collective consciousness through grounded principles that honor body, mind, and spirit. Criteria for certification are based on following attributes: Completion of courses, an interview, and/or short written description of important learning This will be a way of demonstrating comprehension of material and ability to articulate to others. Maturity and ethical conduct. All relevant fees paid in full. I have read and understand all the above and agree to its conditions. Signed:______________________________________ Date:____________________ Send completed form by e-mail to Lynne Michelson  HYPERLINK "mailto:Coordinator@SacredCenters.com" Coordinator@SacredCenters.com or mail to: Sacred Centers 400 Upper Road San Rafael CA 94903 Interested in going further with your journey? 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