Application

Application to the Castellino Prenatal and Birth Therapy Foundation Training

Download pdf application form

PREREQUISITES FOR APPLYING TO THE FOUNDATION TRAINING

A minimum of one Process Workshop with Ray, Mary, Tara or a certified process workshop facilitator. It is recommended that this be within the last 3 years.
OR
The three Days Introductory workshop on Prenatal and Perinatal Imprints in September in Spain with Ray, Mary and Tara or the three days workshop in London on Pre and Perinatal Sequencing Imprints with Ray. If you have not taken a Womb Surround Workshop with Ray, Mary or Tara one of these introductory courses will make it possible for you to apply for the Foundation Training.

  • Highly recommended to have taken at least a five-day introduction to biodynamic / fluid tide craniosacral or polarity therapy or the equivalent (see website under ‘C/S’).
  • Ray, Mary and Tara do not train anyone who uses nicotine or recreational drugs. Applicants must have a commitment to themselves and the people they work with that they will be nicotine and drug free from the time of application through completion of the Foundation Training and must have the intention to abstain for the rest of their lives.
  • A commitment to abstain from alcohol the day before and during all workshops and training modules including breaks and evenings is required.
  • If anyone has any questions about these prerequisites we are open to talk with you about it.

Application for the 14th Castellino Prenatal & Birth Foundation Training (T14) with

Mary Jackson, RN, LM, RCST®, Tara Blasco, PhD, RCST®

and Ray Castellino, DC (retired), RPE, RCST® (2 modules)

 Please include in your application:

  • digital photo (separate from the application, not imbedded in the Word doc.)
  • A process workshop application unless you have previously sent a digital copy to Tara Blasco. If you have already sent a digital copy to her, Tara will collate this with your email and forward to the other trainers.
  • This application to the 14th

 Please fill in your form below using bold for the answers, leaving the questions in regular font. Ideally, you download the Word document, fill it in, and send it back as an attached file in Word. If you don’t have access to Word, you can download the PDF, abbreviate the questions, and write the answers in bold in any word processing format and then send that as a PDF by email. Do NOT send in ‘Pages’; we can’t open it. If you don’t have Word, use a pdf that can be read by macs.

Send these three things: a digital picture of yourself (head shot), this application form and a Process Workshop form if you have not previously sent a digital copy of your Process Workshop application to Tara Blasco at:

formacioncastellinotara@gmail.com
Application for the 14th Castellino Prenatal & Birth Foundation Training

with Mary Jackson, RN, LM, RCST®, Tara Blasco, PhD, RCST®

and Ray Castellino, DC (retired), RPE, RCST® (2 modules)

Include the following information.

Name and any academic or credentials after your name:

Address:

City, State, Zip:

Home Phone:                    Bus. Phone               Cell Phone:

Best phone to reach me:

Fax:

Email:

Website:

Skype address:

Age and Date of Birth:

Family: Married? Partnered? How long? #children, grandchildren, ages, names

 

What is your goal in taking this training including how you plan to use it?

 

Training in bodywork, healthcare, education, counseling skills, movement, mental health, pre and perinatal work, trauma resolution, anatomy, physiology and related fields and in education (include teacher, title of courses, dates, #days/hours as well as certifications received):

 

Current occupation (how you earn a living) and training for that.

 

Description of the nature of your professional bodywork/healthcare/healing arts practice and work with children during the last 5 years.

Therapies used; minimum-maximum clients/week; years in practice, workshops taught, modalities used.

Describe your strengths and challenges as a healing arts professional or a professional working with children.

If you include volunteer work or peer exchange, note it as such.

If you include a vitae, please also summarize your experience.

 

Describe your experience working with pregnant parents, babies and children (your own, others, professionally).

 

Craniosacral training and experience:

  • Training in the fluid tides with teacher’s name, dates and length of the training. Indicate if you have received an RCST or BCST.
  • Training in other cranial sacral modalities with teacher’s name, dates, and length of training.
  • Experience teaching or assisting craniosacral courses: introductions or trainings, Specify modality, length of trainings, teacher.
  • Experience teaching or assisting craniosacral courses: introductions or trainings, Specify modality, length of trainings, teacher.
  • Amount of time using craniosacral work in your professional practice.

 

Describe your health condition & recent medical history, including any current medications for physical and/or mental health.

 

Are you able to commit to all 6 days of all 8 modules including being ready to start on time the first day and staying until the end on the last day?

 

Are you willing to abstain from alcohol from the day before the start of each module through the end of each module?

 

Is your lifestyle nicotine and recreational drug / ceremonial drug free and can you commit to remaining that way for the 3 years from now through the end of the training?

 

Are you using medical marijuana? ____ If yes, please indicate how often and the reason for its use.

 

Are their any challenges for you to taking the training?

 

 

If you have taken a womb surround process workshop with someone other than Ray, Mary or Tara, please indicate when and with whom._____________

 

If you are applying after taking a womb surround from a certified womb surround facilitator other than Ray/Mary/Tara, write below: “I give permission for Ray, Mary and Tara to talk to_______________________.” (the certified process workshop facilitator)

 

 

Print name: ________________________________

 

 

Signed __________________________________   Date __________________

 

(you can ‘sign’ your name by typing it into the application form).

 

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