TREE OF LIFE CENTER
2025 Application for Registered Polarity Program Level -2
We are a Nationally Certified Continuing Education Provider with NCBTMB # 3129991-00
& and American Polarity Therapy Association (APTA) Approved school.
Name _______________________________ Pronoun____________ Date of Birth _________________
Address____________________________________________________________
Phone’s (cell) __________________________(Other)________________________
Email______________________________________________________________
Occupation________________________________________________________
I would like NCBTMB Continuing Education for my NC LMBT Licence __________________
I am interested in pursuing the APTA training levels to become a BCPP (Board Certified Polarity Practitioner)_____
I am already a licensed healthcare provider and would like to add Polarity Therapy to what I do________
Other____________________________________________________________________________
_______ I am applying to the 2025 Tree of Life Center RPP program.
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Complete the application & Fee of $75 and email it to jmdchi@mindspring.com or mail it to the address below.
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Place a $325 deposit of commitment to the program by Feb. 21, 2025 (Both go toward tuition)
Please send a $75 application fee. Once accepted a deposit of $325 is due by Feb. 21st, 2025 that will go toward your tuition. Venmo @janiceMarie-Durand or mail a check to 4316 Bradford Ridge Rd. Efland, NC 27243
Occupation and other professional credentials:
Please complete these application questions via email to jmdchi@mindspring.com:
A. What are your intentions or goals with participating in this RPP level of polarity therapy training?
B. Describe pertinent training, experience, and bodywork you have participated in and received.
C. Describe any gifts that you can bring to the group and the learning process.
D. Describe any learning challenges you have individually or any challenges you have in groups. Share any feedback from past TLC programs that will help us meet you most effectively as a student.
E. Are you willing to reach out for support with outside resources such as counselors or Somatic practitioners if you need that during the training period if things are coming up for you?
F. Describe any resources or things that help you when you are stressed out.
G. Do you have any days, times, and dates that you are unable to participate from April to Dec. 2025
H. If you are applying from another Polarity Therapy program please provide details of where, when, and how many hours you have studied.
Payments Options include:
-Venmo @JaniceMarie-Durand
-Cash or, -mail a check made out to Janice Marie Durand: 4316 Bradford Ridge Rd. Efland, NC 27243
Tree of Life Center
Attn. Janice Marie Durand
4316 Bradford Ridge Road
Efland, NC 27243