This will be an easy, fast process, please complete each area and I look forward to speaking to you soon - Laura
Have you listened to the Lighting Process Home Study Audio?*
Yes I haveNot Yet
Are you willing to attend and participate in the discussions, training and coaching sessions?*
How did you find us?*
---GoogleSocial MediaWord of MouthHealth ProfessionalME Society/ Support Group
Briefly describe your previous history*
How would you describe your illness/ symptoms/ issues? (Inc. any medical diagnosis)
Date of Diagnosis
Do you require wheelchair access to get to the venue?*
Do you feel you can influence your own health?*
Do you feel you can get better/ resolve your issues?*
To help me asses your suitability for the seminar, please tell me if you have any medical or mental health issues that you have not yet mentioned on this form. If so, please list them*
What do you hope to achieve from the course?*
When you have discovered a way to get well and resolve your issues, what you would love to do next?*
Have you applied to take the training before?*
Would you like to be accompanied at the seminar?*
As space can be limited on some courses, please discuss availability with your practitioner during your phone call, if you would like to be accompanied. This person will need to complete a separate Learning Facilitator form.
Do you agree to maintain confidentiality with regard to personal information shared by others during the training?*
The training fees for taking the Lightning Process training with Laura Dumbleton-Jones are: £695 per person in a group of up to 5 people and £895 for one to one.
This includes 15 hours worth of Lightning Process Training over 3 consecutive days and 3 hours follow up support via skype or over the telephone which is available for up to 12 months.
Payment is required by online bank transfer and is payable once you have been accepted onto the course.
You should only sign this application form if you agree to the terms and conditions below and to the following statement:
"I understand that the Lightning Process is a training programme. Its purpose is to train me in the tools of the Process, and I realise that simply attending will not guarantee me any results. I recognise the changes I want can best be obtained by fully participating and engaging in the seminars and continuing to apply it after. I am ready and committed to do this."
Terms & Conditions
Date of Signature
So that we can contact someone close to you in the case of an emergency please provide:
Emergency Contact Name*
Emergency Contact Number*
Under 18 years of age?
The following must be completed if you are under 18 years of age:
If you are under 18 years of age please ask your parent/guardian to read through the form and if they also agree to the terms and conditions, for them to sign the form too.
Parent/ Guardian Name
Parent/ Guardian Signature
Date of Signature
Relationship to Applicant
You can decide to have your attendance certificate logged, together with your name, certificate number and email address with the Lightning Process Head Office. This will:
If you would like this option please check this box.
In addition to the logging of your details for the purposes outlined above, we would also like to occasionally inform you of relevant developments in the Lightning Process® and its associated programmes. This is an optional service. Your details will never be passed on to anyone else for any reason.
Please check this box if you wish to receive occasional and relevant correspondence from us about this.
In order to conduct further research into the Lightning Process we would like to contact you at regular intervals to monitor your progress. We will not use any details by which you may be identified in any statistics that we produce.
Please check the box if you agree to this.