Associate Member (please complete sections 1 & 2)

Practitioner Member (please complete sections 1, 2 & 3)

Teacher Member (please complete all sections)

Section 1: Personal Details (all applicants)

Name: Mr Miss Mrs Ms

Address 1:

Address 2:

Address 3:

Post code: Country:

Tel: Fax: E-mail:

Section 2: Training (all applicants)

Please give details of the Metamorphic Technique courses/workshops you have attended. Please also attach copies of you attendance certificate(s) with this form (or written confirmation of attendance from your teacher).

Section 3: Practical experience (Practitioners & Teachers) Please give details of your experience of practising the Technique:

Approximately how many one-hour sessions have you given: (In the last 12 months) (In total)

Approximately how many people have you given sessions to: (In the last 12 months) (In total)

Approximately how many sessions have you, yourself, received: (In the last 12 months) ( In total)

Section 4: Teacher training and experience (Teachers) Please give details below:

I confirm that I have:

• been a Practitioner Member since (insert date)
• completed a teachers training course with (course leader) at (location) on (dates)
• given (insert number) talks/presentations on the Metamorphic Technique.
• given (insert number) courses/workshops on the Metamorphic Technique.

Please submit the following along with your application:

• details of the dates and locations of talks/presentations and workshops given
• a copy of your workshop plan
• feedback forms from at least 10 students

Signature (all applicants)

I have read and accept the conditions of membership and wish to apply for membership of the Metamorphic Association as per the information above. Those applying for Practitioner or Teacher Membership should also read the Code of Professional Practice and agree to comply with it before submitting their application.

Signature............................................................................................. Date.........................................................................

Payment details (all applicants)

Membership subscriptions run annually from October to September; those joining during the year pay a part-year fee. Please select the relevant amount you are enclosing according to the date when you would like to join.

Please select category Associate Member - £12 Practitioner Member - £60 Teacher Member - £100 Please select category Associate Member - £9 Practitioner Member - £45 Teacher Member - £75 Please select category Associate Member - £6 Practitioner Member - £30 Teacher Member - £50 Please select category Associate Member - £3 Practitioner Member - £15 Teacher Member - £ 25

Checklist - have you enclosed

payment workshop attendance certificates(Associates and Practitioners) Teachers' supporting documentation

For office use

Application accepted by ..................................................................... Date.........................................................................

Please print out this form and send it with all the necessary enclosures to:

The Metamorphic Association
159 Bembrook Road
Hastings
East Sussex
TN34 3PD
United Kingdom

Please make cheques payable to 'The Metamorphic Association'. If sending a payment from outside the UK, please send an international money order.

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