Thanks for your interest in the GLT-USA Grof® Breathwork Facilitator Program. We are excited to know more about you and your interest in facilitation work. 

Please complete the following application. We will automatically receive your application electronically. Please note that responses to open-ended questions are limited to 3500 characters, which translates roughly to 500-875 words, more than enough for your response. Questions marked with an asterisk (*) require an answer for submission of the application. Questions not so marked are optional for response. 

A deposit of $100 is required to submit your application. You may pay this deposit by bank card after you complete the application. If you are not accepted into the program, this deposit will be refunded. Upon acceptance into the training, the full application fee will be applied to your enrollment deposit. If you are accepted into the training but decide not to go forward, there is no refund of the application fee. 

We will get back to you by email as soon as practical after you submit your application. If we believe dialogue would be helpful for us or you, we may be in touch to schedule a brief interview within the next few weeks. If you have any questions, please contact Jay Dufrechou at jay@grof-legacy-training-usa.com.

Finally, please note that after you complete our application, SurveyMonkey, which we are using for our applications, may take you to a screen that invites you to complete an independent survey not associated with our program. That offering is not from us and you may of course ignore it. 

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* 1. First Name

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* 2. Last Name

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* 3. Preferred Name

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* 4. Email

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* 5. Phone Number

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* 6. Address

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* 7. Date of Birth

Date

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* 8. Gender Identification

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* 9. Pronouns

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* 10. A prerequisite for this training is completion of an introductory survey course in the work of Stan Grof. Please indicate whether you have completed such a course or that you will contact us to note your plans for completion of this requirement. We prefer completion prior to entry into the program but prior completion is not necessary for application.

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* 11. Level 1 of the Grof Breathwork Facilitator Training Program requires a significant personal and financial commitment. Please help us understand why you are applying for the program. What is motivating you to enter this training with GLT-USA at this time?

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* 12. What are your professional hopes and expectations for this course?

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* 13. What are your personal hopes for this training?

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* 14. How does Grof Breathwork factor into your overall life goals?

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* 15. A prerequisite for this training is a minimum of four breathwork sessions in the Grof lineage. We consider one session to include both breathing and sitting. For instance, a weekend workshop where you breathed once and sat once would count as one session; a retreat where you breathed twice and sat twice would count as two sessions. Sessions under brand names Grof Breathwork, Holotropic Breathwork, or Transpersonal Breathwork (Dreamshadow community) count as sessions in the Grof lineage. Other experiences may be considered with approval from Jay Dufrechou but strong emphasis is on experience in the Grof Breathwork/holotropic breathwork modality. BodhiBreath sessions including sitting may be counted but please note that BodhiBreath is a somewhat different modality. One BodhiBreath session without sitting may be counted toward this requirement without consultation with us. Please list four sessions in which you have participated, including place, approximate date, and lead facilitator name. Please note that you may apply without completing four sessions but should communicate with Jay at jay@grof-legacy-training-usa.com about your intention to complete additional sessions.

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* 16. If you listed a session above other than Grof Breathwork, Holotropic Breathwork, Transpersonal Breathwork or BodhiBreath, please describe the nature of the session(s). 

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* 17. If you have additional experience with breathwork in the Grof lineage, please estimate your total number of breathwork sessions in our lineage (including the four sessions noted above).

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* 18. What have you learned personally from your breathwork sessions. Are there ways that the experience has invited a shift in your established beliefs and views? If so, please tell us something about that.

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* 19. What have you learned from your experience as a sitter?

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* 20. Do you have experience with psychedelics/entheogens/plant medicines?

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* 21. If you have experience with psychedelics, what is your current relationship to these practices?

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* 22. How do you imagine experiences with psychedelics/entheogens/plant medicines or other nonordinary state practices intersecting, or not, with Grof Breathwork?

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* 23. If you have practices or experiences related to nonordinary states of consciousness, other than Grof Breathwork or psychedelics, please describe these practices or experiences and indicate how you imagine them intersecting with Grof Breathwork, if at all.

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* 24. While there is a strong emphasis on personal inner development in our programs, Level 1 of the Grof Breathwork Facilitator Training includes attention to interpersonal process, group dynamics, and consideration of holding and facilitating groups. The Cohort Group provides particular focus on this aspect of our training. Over our time together, we will engage with what arises in the group, including shadow, biases, and other unconscious material. This may be uncomfortable at times. Please describe your experience and/or level of interest in working with group dynamics. 

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* 25. What do you look for in a group container that supports psychological safety while also encouraging introspection and growing capacity?

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* 26. How do you contribute to others' sense of safety, introspection and growth?

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* 27. Please describe inspirational and/or self-care practices that you find supportive. How often do you engage in these practices and what benefit do they bring you? 

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* 28. What if any forms of art or creative expression do you practice or explore? 

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* 29. How do you describe yourself professionally?

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* 30. Our program does not require any particular level of education, degree, prior certifications or license for admission. However, we hold the intention that our certified facilitators will be familiar with and conversant in the extensive written work of Stan Grof. Our program includes reading, writing, personal and academic reflection, and responding to basic quizzes to help integrate the material in our program. Please share your interest in this aspect of our program and any prior relevant experience.

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* 31. What is your highest level of formal education?

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* 32. If you studied beyond high school, please indicate areas of study.

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* 33. Please note any relevant prior trainings or certifications

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* 34. What are your plans for engaging in this work following completion of the Grof Breathwork Facilitator Training program?

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* 35. Please upload a recent photo of yourself

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* 36. Is there anything else you would like us to know about you?

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