Certificate Program Application

Certificate of Study in Process Work
Application

Date of Application: _____________________________________________________________________

Name: ________________________________________________________________________________

Address: ______________________________________________________________________________

Telephone/Fax: __________________________________  Email: ________________________________

Date of Birth: __________________________________________________________________________

Academic Credentials: ___________________________________________________________________

______________________________________________________________________________________

Current Occupation: _________________________________Number of Years Experience: ____________

I. Essay Questions
Please respond to the following questions on a separate sheet of paper and attach to this application.

• What are your reasons for studying Process Work and how do you hope your studies will further your personal development?

• How do you hope to apply Process Work to your professional work and how do you imagine it supporting your dreams for world change?

• Give us a brief autobiographical statement, highlighting the academic, professional, and personal experiences which are most meaningful to you.

II. Letter of Recommendation
Please include a letter of recommendation from a Certified Process Worker.

III. Application Fee
Please include all of the above with your application fee of $100 (check or money order) payable to the Process Work Institute.  The check must be in U.S. funds and drawn on a U.S. bank.  Please return the check, application, letter of recommendation and essay questions by mail to:

Process Work Institute

2049 NW Hoyt St
Portland OR 97209